FYI... tidbits on health policy processes/example



The responsibility for policy making is shifted between the legislative and executive branches.

Department and agencies in the executive branch are established and sustained and the individuals employed within them carry out the intent of the law as enacted by legislators who rely on implementation to bring laws into fruition. A mutual relationship between those who promulgate policy and implement it exists.


In order for a policy to be affective in determinants of health it has to be implemented efficiently. The process of promulgating a policy is made more dynamic than it would be because of the constant revision and formulation of new rules made to implement it.


The role of executive agencies is to carry out the laws formulated by the legislative branch. The legislative role involves ensuring that implementing organizations adhere to congressional intent and ensure that implementation of policies reflect the issues important to the public. The judicial role involves the hearing of appeals from organizations or individuals who may not be satisfied with the way the implementation of a policy affects them.


Rules established to implement health related public laws often target members of interest groups since every policy affects one or more of them. Lobbying is on form of influence interest groups use when they strongly support the formulation of a particular law on the manner in which it should be implemented.


The goal is that all parties involved with the policy implementation process undertake the operation of the enacted legislation in a manner that appreciates the intent behind the legislation. This includes rulemaking under which implementation will move on and go into operation. 


One example of this process found in the text is CMS. This is a federal implementing agency that was created in 1977 to implement the Medicaid and Medicare programs. It also administers the Children’s Health Insurance Program (CHIP) that guarantees that uninsured children have medical coverage (Centers for Medicare & Medicaid Services [CMS]), 2010a). CMS is also responsible for public laws that established and continue the aforementioned programs. The agency is organized around three centers to support its major functions. Each center has a distinct role to assure successful implementation of policy (Longest, 2009). The most significant legislative change to Medicare--called the Medicare Modernization Act or MMA--was signed into law by George W. Bush, on December 8, 2003. This legislation added an outpatient prescription drug benefit to Medicare made other changes (CMS, 2010b).


Centers for Medicare & Medicaid Services (2010a). National Chip Policy: Overview. Retrieved from


Centers for Medicare & Medicaid Services (2010b). History: Overview. Retrieved from

Longest, B.B. (2009). Health policymaking in the United States. (5th ed.). Washington: AUHPA

© Quitah Haille

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It is true that all branches of law - legislature, executive, and judicial - have a mutual relationship. This supports the continuity of law, which may include their liberty to break it.


However, there is a greater law - a spiritual law - that our government respects - for it is In God We Trust; thus, physically promulgating the separation of Church and State while spiritually operating on a higher principle.


We adapt and evolve (at least some of us do) so the need to continue to revise and formulate rules is understandable - it is about growth and development. Yet, there should always be a standard - one that does not need revision.


From the spectrum of the petri dish, beakers and tubes, to the ink from the hand of The President of the United States, all of it have an impact on the establishment and enforcement of laws, specifically healthcare.


As far as United States Healthcare, what are our expectations of healthcare accessability, rights and laws?  We do need healthcare reform.  Should the U.S. adopt socialized healthcare and eliminate the lobbyist or do we accept the motivation(s) of the lobbyist and their entities?


C'mon folks, all forms of talent, whether it is the power to pursuade, the gift of dunking a ball in a hoop or the ability of a triathalon are deserving of recognition; however, it is those who protect and serve - the service of parents, teachers, nurses, doctors, scientists, psychologists, therapists, counselors, policemen, firemen, dogs, horses and maybe even some theological teachers that are far more deserving of recognition and admiration.


But who is going to tenaciously lobby that? Really and truly, for a greater healthcare reward, change is good; yet it is the what and how that is changing and whose the advocate(s) of revision - the branches alone or the branches with its' foundation? 


R Herelle




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