ABSTRACT
Healthcare policy refers to the study of the health outputs and outcomes generated by a society, as well as how societies create the laws and regulations by which the healthcare sector is governed in its structure and functioning. This function inevitably involves politics (who gets what, when, how), because inherently self-interested individuals and organizations have differing priorities and imperatives concerning the distribution of healthcare resources. The process is also inevitably shaped by the unique social, economic, political, and cultural characteristics of each nation. The health policy process involves a wide range of individuals and institutions, and can be best envisioned as cyclical in nature: inputs, policy formation, outputs, implementation, outcomes, and then modification (leading back to inputs in the cycle). The United States has a system and national ideology of limited and divided federalist government, stemming from the nation's creation as a reaction against English “tyranny” and distant, centralized government. As a result, most policy change (including the enaction of Medicare for seniors and Medicaid for seniors and the “deserving poor”) has been incremental, and often opposed on the grounds of government power-seeking and intrusion into private business and personal life. Not surprisingly, then, the 2010 Affordable Care Act (ACA), the U.S. attempt to provide a national health insurance system, is much more decentralized and market-oriented than the systems of most other economically advanced nations. The United States, like other nations, faces serious cost, quality, and access problems, as well as the challenge of using new technologies cost-effectively.
