Health Policy in America: Do Changes Need to Be Made to Better Prepare for Pandemics?

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Two women wearing medical protective masks stand next to a laptop in an office; one of them points to the screen.Fighting a pandemic calls for robust public health policy. The COVID-19 pandemic has made this clear. At the federal, state, and municipal levels, public health policies have provided a framework for mounting a strategic response: surveillance of the disease’s spread, public health awareness messaging, and development of COVID testing sites.

Health policies create a sense of stability. They reassure people that action is being taken to contain an illness. Given the uncertainty that still surrounds the COVID-19 pandemic, however, it’s worth asking a simple question: Should the U.S. change its public health policy to better prepare for public health crises?

What Is Health Policy?

According to the World Health Organization (WHO), health policy describes the plans, decisions, and actions in achieving a health care goal; health policy is shaped at the federal, state, county, or city level.

Benefits of Health Policy

The following sections discuss the advantages of a clearly defined health policy.

•Vision Setting

Health policy provides society with its goal for what an effective health care system should look like; it provides a way to set short- and long-term goals.

•Defining Roles

Another critical benefit to health policy is that it clearly defines roles and responsibilities, such as for the federal government and local hospitals. 

•Consensus Building

When public health experts come together to form health policies, it allows them to unite around shared ideas and priorities and build a consensus. 

•Awareness Raising

By establishing a clear health policy, the government can convey goals, strategies, and expectations to the public, keeping citizens well informed.

•Impact of Health Policy

Health policy encompasses the laws, regulatory actions, funding priorities, and courses of action (or deliberate inaction) by government representatives. Medical organizations across the country feel the impact. The following sections contain some examples.

•Community Health Clinics

Health policy may lead to a community health clinic being established to provide access to care for low-income individuals.

•Reporting

Health policy may impose reporting requirements on doctors and nurses, requesting that they submit clinical data to a public health database. 

•Federal Funding

Health policy dictates federal funding provided to clinical trials, government research projects, and more. 

•Individual Mandates

Health policy may even impose a mandate on individual citizens; for example, consider states or counties that have required masks during the COVID-19 pandemic.

Health Policy Issues in Care Delivery Systems

Health policy shapes the way nurses and physicians can deliver care, and, in some cases, it can create obstacles, including those associated with health coverage and treatment costs. Such obstacles have prompted many physician and nurse leaders to become involved in advocacy work for better health policies, with the aim of more efficient care delivery.

How Health Policy Affects Care Delivery

Health policy can have a significant impact on medical care’s accessibility and affordability. For example, states that have expanded Medicaid, under the Affordable Care Act (ACA) provisions, have reduced the percentage of their population that’s uninsured and made it possible for more people to receive treatment when they need it.

Health policy can also provide incentives for patients to seek proactive or preventive care from physicians. For example, the ACA allows most patients to receive wellness checkups at little or no cost, and patients can also receive prescription birth control without a large out-of-pocket expense.

Such provisions make it more likely that patients will be proactive in seeing their physicians for checkups and routine visits — increasing the likelihood of diseases being prevented or identified earlier.

Voices for Reform

While health policy can sometimes facilitate efficient care delivery systems, many medical leaders have identified areas of potential reform. Organizations like the American Medical Association (AMA) serve to amplify the voices of physicians who wish to remove obstacles to patient care, and to provide further resources for clinically sophisticated treatment.

For example, AMA members have championed Medicaid expansion in all 50 states, aiming to increase the percentage of the nation’s population that has robust health coverage. The AMA has even filed lawsuits to remove Medicaid work requirements and other legislative obstacles to patient care.

A Look at Current Health Policy Issues

Several current health policy issues have a direct impact on care delivery. These issues include prescriptive authority for nurses, pharmaceutical pricing, and surprise billing.

Prescriptive Authority for Nurse Practitioners

One of the most significant current health policy issues is the level of autonomy afforded to nurse leaders —particularly nurse practitioners. In some states, nurse practitioners lack full practice authority, which means they can only diagnose and treat patients if they have a working or supervisory relationship with a credentialed physician. In other states, nurse practitioners lack prescriptive authority, meaning they can only prescribe medications if they have a working relationship with a physician.

Many advocates say nurse practitioners play a significant role in providing patient care and addressing the looming shortage of licensed physicians. According to these advocates, the lack of full authority across the nation is an obstacle to nurse practitioners’ delivering care.

Pharmaceutical Costs

According to Modern Healthcare, the high cost of prescription medications is one of the most significant issues that medical lobbyists and patient advocacy groups are currently addressing.

The article notes that high prescription medication costs make it difficult for patients to receive needed interventions. Medical lobbying groups have voiced support for legislation such as the Senate’s bipartisan Prescription Drug Pricing Reduction Act, which would increase discounts on certain drugs, particularly for Medicare patients.

Surprise Billing

Surprise billing is another health policy issue that has won the attention of patient advocates and physician lobbyists. According to the AMA, too many patients wind up with unexpected bills that they can’t afford, which makes some individuals reluctant to seek care in the first place.

The AMA notes that “patients should only be accountable for normal in-network cost-sharing amounts.” The organization also supports legislative guidelines to minimize the risk of surprise billing, as well as provides an independent resolution system for disputes between physicians and insurance companies.

What Is Public Health Policy?

Current health policy issues highlight how legislation and lobbying affect the way citizens access affordable medical treatment. Such policies are always consequential, but they can be especially impactful during a pandemic, when illness spreads quickly and economic uncertainty is high.

Additionally, the public health policy field affects overall health and wellness. In a sense, public health policy can be viewed as a series of goals, laws, regulations, and spending priorities expressly intended to improve health and safety for individuals as well as communities.

Examples of Public Health Policy

Several public health policies have had a positive effect.

•Seat Belt Laws and Public Health Policy

Seat belt laws compel drivers and passengers to take the proper safety precautions any time their vehicle is in motion. This decreases the prevalence of serious automotive injuries and fatalities.

•Public Smoking Bans

Public smoking bans, along with public health messaging about the dangers of smoking, contribute to a decrease in secondhand smoke and its harmful consequences.

•Gun Violence

Certain public health issues continue to warrant advocacy from physician groups. A major issue is gun violence. The AMA supports the Senate’s Bipartisan Background Checks Act of 2019, and it successfully lobbied for federal funding to research gun violence issues.

Ongoing Public Health Policy Issues

Gun violence is just one example of an ongoing public health policy issue. Several other public health concerns have spurred physician leaders to mobilize.

Chronic Conditions and Public Health Policy

A current issue is chronic disease. According to the American Public Health Association (APHA), Americans are living longer, but chronic conditions like cancer, heart disease, and diabetes are eroding their quality of life.

These serious health problems are preventable.

The APHA notes that public health policy can reduce risk factors by promoting vigorous, healthy lifestyles. Examples include encouraging physical fitness, advocating for sound nutrition, and providing resources for kicking the tobacco habit.

Mental Health and Public Health Policy

Mental health is another important public health policy issue. Mental Health America (MHA) is an advocacy organization that pushes for improved treatment options for people with mental health disorders. Specifically, MHA has a policy platform that encompasses preventive services, early diagnosis protocols, and integrated care (when mental health specialty and general medical care providers work together to address patients’ physical and mental health needs).

Racial Inequity and Public Health Policy

Another issue to note is racial inequity in health care. The APHA offers a succinct summary of the problem: “Racism hurts the health of our nation by preventing some people the opportunity to attain their highest level of health.” The organization has declared racism to be a public health issue. It champions racial reconciliation as a necessary step toward an overall healthier society.

Suicide and Public Health Policy

Public health officials have long seen suicide as a health issue of great importance. The WHO notes that almost 800,000 people die by suicide each year, and that doesn’t include the countless individuals who attempt suicide. An overwhelming majority of suicides and suicide attempts happen in low- or middle-income areas, leading many advocates to believe that socioeconomic issues contribute to the problem and that better public health policies can address those issues.

Pandemic Plans and Public Health Policy

Clearly, public health policy can have wide-ranging effects, and it can touch on many issues. Arguably among the most important issues are pandemic preparation and response.

Comparing Pandemic Plans

U.S. history is filled with examples of how public health advocates responded to significant crises. Consider the examples in the following sections.

•The Flu

In 2005, the White House Homeland Security Council began outlining response plans for dealing with nationwide flu outbreaks. As the Centers for Disease Control and Prevention (CDC) notes, these flu pandemic plans focus on stopping or slowing the infection rate.

•Ebola

In response to the 2014 Ebola outbreak in West Africa, the CDC launched pandemic plans focused on simultaneously controlling the situation in Africa while preparing the U.S. for the possibility that it could spread to these shores.

Impact of Pandemic Plans

Pandemic plans are complicated by their impact, not only on physical health and infection control but also on the nation’s socio-economic and psychological health.

During the current COVID-19 pandemic, socioeconomic fallout has played a significant role in the ongoing discussion about a pandemic response. Some have argued that temporarily shutting down businesses and schools, in an effort to control the virus, will have a negative effect on the economy. Others have countered that only by getting the disease under control can we begin shoring up the economy in earnest.

Pandemic plans also affect the nation’s morale. In particular, a clear public health message can cause individuals to feel either more or less reassured that the situation is under control.

Pandemic Policy and COVID-19

As the COVID crisis unfolds, it highlights many vulnerabilities in current health policy. It also points to potential areas for improved pandemic preparedness.

COVID-19 and Health Care Inequities

A pandemic side effect has been a renewed focus on health care inequities. The pandemic has disproportionately impacted Black, brown, and other vulnerable communities, as well as low-income communities, according to an NPR report. Public health experts say the pandemic has emphasized existing structural inequalities, which results in inequitable access to medical care.

COVID has also highlighted the challenges associated with employer-sponsored health insurance. According to the Kaiser Family Foundation, about 27 million Americans risk losing their insurance coverage due to economic duress.

Preparing for the Next Pandemic

Many experts have surveyed the shortcomings with current pandemic policy and proposed that changes must be made before the next public health crisis comes.

Based on the U.S. response to COVID-19, Fortune calls for broad changes to American health policies. The proposed changes include the following:

  • Development of stronger public health systems to detect and contain diseases
  • Improved public health communication and coordination
  • Response to “the underlying inequalities that make a crisis like this one so devastating for vulnerable people”

Essentials of Health Policy and Law

In considering both the strengths and the relative weaknesses in U.S. health policy, including pandemic policy, it can be helpful to look at the components that tend to create these policies.

Forming Health Policy

When developing or refining health policy, policymakers undertake a typical process:

  1. Problem identification. Clarify the scope of the issue and its impact on the community. The advocacy of physicians and nurses is significant here, as they see obstacles to effective patient care firsthand.
  2. Policy analysis. Review the current policies that impact this problem and suggest new or modified policies.
  3. Strategy and policy development. Craft new rules, regulations, advisories, or funding priorities that can have a positive impact on the community.
  4. Policy enactment. Follow the legal or departmental guidelines for putting the new policy into place.
  5. Policy implementation. Communicate the new policy to stakeholders and begin to monitor and review its impact.

Using Health Policy

Health policies dictate a national, federal, or municipal approach to community health needs. Health policies also reference points for hospitals and health care organizations as they craft their own internal policies. Public health plans offer benchmarks and best practices that are easily adaptable to individual health care settings.

Pursuit of Optimal Health Policy

Health policy directly affects communities’ well-being. It determines how easily providers can treat patients. Not only that, in a pandemic’s shadow, healthy policy lends itself to rethinking and revising, in an effort to better serve the population. One way to have a voice in this dialogue is to pursue a formal education in health policy. Start by learning more about Ohio University’s online Master of Health Administration program.

Recommended Readings

Hospital CEO Career Outlook and Salary
What Is Epidemiology? Definition, Types, and Careers
Health Information Systems: Health Care for the Present and Future

Sources:

Anchorage Daily News, “COVID-19 Pandemic Highlights the Importance of Public Health”
Brookings, “Current Debates in Health Care Policy: A Brief Overview”
Forbes, “Government Policies are Driving Doctors to Quit Health Care”
Healthy People, Law and Health Policy
JAMA Network, “Governmental Public Health Powers During the COVID-19 Pandemic”
SAGE Journals, “Developing a Sustainable Exit Strategy for COVID-19: Health, Economic and Public Policy Implications”
SAGE Journals, “The Importance of Policy Change for Addressing Public Health Problems”
Scope of Practice Policy, Nurse Practitioners Overview