By Johnny Blogger – as consultant with the Chicago Lakeview Psychotherapy group, 2nd Story Counseling.
The topic of healthcare policy for mental health, psychotherapy, disease prevention, general medicine, including access to and administration of, is an extremely complex and at times politically contentious issue in the United States of America. This is in large part due to the many stakeholders who are part of the healthcare continuum. This brief paper will explore the various roles of these stakeholders and relate them to the entire field of public health policy. A reflective conclusion will be offered as a summary.
In the larger view, every single person in the United States of America can be viewed upon as a stakeholder in healthcare policy making. In a macro-view, there exists several subtypes that are important to discuss in order to more clearly identify the various players. What follows is a basic illustration of these stakeholders as identified by Teitbaum & Wilensky (2007) in their textbook, Essentials of Health Policy and Law.
The most important stakeholder in the healthcare policy making, in this writer’s opinion, is the patient. There are several factors that are of primary importance to patients regarding healthcare policy. These factors include:
Affordable access to healthcare remains a challenge for many in the U.S. according to a 2008 United States Census report with government programs cover approximately 27% (83 million) of the entire population (U.S. Census Bureau, 2008). This same report suggests that that approximately 50 million people in this country have no healthcare insurance at all. Patients (human beings) are big stakeholders in healthcare policy decisions.
Healthcare providers, which includes medical doctors. dentists, specialty practioners (i.e. mental psychologists, chiropractors) and other allied health professionals can all be considered major stakeholders in the healthcare policy formulation and decision making process. There currently exists huge, voluntary membership organizations which represent these various stakeholders. For example, the American Medical Association is “the voice” of physician providers in the United States.
Formulation of healthcare policy, which in many cases for providers is focused on payment, is important to this stakeholder group. Medicare, which is a U.S. government operated healthcare program, is often criticized for its low payment per procedure ratio by this group (Macgillis, 2009).
Government & Insurance Providers
The government, both state and federal, can be considered major stakeholders in healthcare policy making. As discussed earlier in this paper, some 83 million Americans receive some type of health coverage from governmental entities. An example of this can be found in Medicare, which is a joint health insurance program that is paid for by the Federal government and state governments. Primarily, Medicare covers people who are 65 years of age or older. According to Medicare.gov, the program currently covers over 40 million Americans (Medicare, 2010). It makes sense that the government would be a major stakeholder in healthcare policy decision making as the government is one of the larger players.
Insurance providers, such as Blue Cross and Blue Shield. Aetna, Cigna and many others are also “major” stakeholders in healthcare policy and decision making. This writer would also like to point out that insurance providers are also very influencial in the healthcare policy and law decision making process. These corporations have billions of dollars to donate to political campains and efforts that are designed to help shape public health policy debate among the public and lawmakers.
As mentioned at the beginning of this paper, everyone can be considered a stakeholder in healthcare policy decision making. Everyone means the general public. Much of the law regarding public health is conerned with health adminstration, wellness promotion and disease prevention. Collectively, it is the public that most major healthcare initiatives are aimed at. An example of this might be the Centers for Disease Control and Prevention urging people to recieve their annual influenza immunmization shot. Laws and policies, in general terms. are designed to promote public health and prevent illness.
There are many stakeholders involved in public health policy formulation and decision making in the United States. These include patients, healthcare providers, the government and insurance providers and of course, the general public. It is noteworthy to point out that money has a major influence on shaping the debate of healthcare policy and law in the United States as witnessed in the recent healthcare reform that became law in 2010. There are of course other stakeholders that are on a smaller scale, such as medical equipment providers, healthcare advertisers and so forth. This paper focused on the major stakeholders in healthcare policy decision making on the larger view.
Macgillis, A. (2009, October 13). Mayo Clinic Faulted for Limiting Medicare Patients. Retrieved November 27, 2010, from Washington Post: http://www.washingtonpost.com/wp- dyn/content/article/2009/10/12/AR2009101202803.html
Medicare . (2010). Medicare eligibility. Retrieved November 27, 2010, from www.medicare.gov: www.medicare.gov
Teitbaum, J., & Wilensky, S. (2007). Essentials of health policy and law. Boston: Jones and Bartlett.
U.S. Census Bureau. (2008). Retrieved November 27, 2010, from www.uscensus.gov: http://www.census.gov/prod/2008pubs/p60-235.pdf