Health Policy Commons^™

Justice Roberts’ America, Robin West

Georgetown Law Faculty Publications and Other Works

Less than a week after the Roberts Court issued its decision in National Federation of Independent Business v Sebelius, Jeffrey Toobin, writing in The New Yorker, compared the first part of Chief Justice John Roberts's opinion, in which he found that the Commerce Clause did not authorize Congress to enact the "individual mandate" section of the Affordable Care Act (ACA) that requires all individuals to buy health insurance, with an Ayn Rand screed, noting that the pivotal sections of the argument were long on libertarian rhetoric but short on citations of authority. Roberts held (although "held" might be …

How The Supreme Court's Medicaid Decision May Affect Health Centers: An Early Estimate, Katherine J. Hayes, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The nation's federally funded health centers are the principal source of primary health care for medically underserved populations. In CY 2011, more than 1,200 health centers, operating in more than 8,500 urban and rural locations, served 20.2 million patients, 36 percent of whom were uninsured and 93 percent of whom had family incomes below twice the federal poverty level. Federal grants provide core support to health centers, but Medicaid represents the largest single health center financing mechanism, accounting for 39 percent of revenues. Medicaid revenue growth allows health centers to preserve their core grant funding to reach uninsured patients while …

Making The Case For Public Health: Estimating Roi And Value, Glen P. Mays

Health Management and Policy Presentations

This presentation describes recent progress and new directions for estimating the value of public health strategies and infrastructure.

An O’Neill Institute Briefing Paper: The Supreme Court’S Landmark Decision On The Affordable Care Act: Healthcare Reform’S Ultimate Fate Remains Uncertain, Emily W. Parento, Lawrence O. Gostin

O'Neill Institute Papers

The Supreme Court’s decision on the constitutionality of the Patient Protection and Affordable Care Act (ACA) is a landmark on the path toward ensuring universal access to health care in the United States. In a 5-4 decision written by Chief Justice Roberts, the Court upheld the law in its entirety with the sole exception that Congress may not revoke existing state Medicaid funding to penalize states that decline to participate in the Medicaid expansion under the ACA. In this O’Neill Institute Briefing, we explain and analyze the Court’s decision, focusing on the individual purchase mandate and the Medicaid expansion, while …

State Health Insurance Exchange Laws: The First Generation, Sara J. Rosenbaum, Nancy Lopez, Taylor Burke, Mark Dorley

Health Policy and Management Faculty Publications

No abstract provided.

Entanglement: Health, Healing And Society In Africa, Haley Noel

Anthós

As a continent, Africa has been explored, exploited, and largely abandoned by the West. During the colonial era of the late 19th and early 20th centuries, foreign powers encountered diverse cultures, superstitions and disease before promptly labeling the entire continent a dangerous and primitive place. For early explorers and colonialists, disease and the threat of ill health is what defined Africa. They overlooked the pre-existing strategies and practices that Africans had adapted to guard against certain diseases, either ignoring them or labeling the misunderstood safety nets as primitive. Also overlooked was the importance of societal organization and communal cooperation among …

Quantifying The Value Of Public Health Investments, Glen P. Mays

Health Management and Policy Presentations

This session reviews recent findings from a series of studies that estimate the health and economic effects attributable to investments in public health services and delivery systems.

Making Sense Of Irish Health Care Management: The Street Level Public Organisation (Slpo)., Vivienne Byers

Conference papers

Public service reform in modern economies has placed an emphasis on effective planning and management of service delivery to the citizen-client. This paper draws on the concept of the Street Level Public Organization (SLPO) to examine the problem of government’s top down implementation of planning reform in the delivery of public services. It does so, by exploring the implementation of strategic planning in the health sector and drawing upon field work from such implementation in the health services in Ireland and Canada. The SLPO model (McKevitt 1998) is used as an explanatory tool to add to the public sector reform …

Developing Service Delivery Measures For Studies Of Practice Variation: The Mprove Study, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: A growing body of evidence indicates that the delivery of public health activities varies widely across states and communities, creating missed opportunities for prevention as well as inequities in health protection. Consequently, HHS recently used a consensus-based process to develop a framework for improving quality in public health and to identify a set of nine priority areas for improvement. As next steps in operationalizing this framework, measures of quality in public health are needed to guide public health improvement initiatives and to support research on the comparative effectiveness of alternative public health strategies. This presentation profiles the methodology developed …

Scale And Scope Effects In Public Health Delivery: Estimating Gains From Regionalization, Glen P. Mays

Health Management and Policy Presentations

OBJECTIVES: Current approaches to health system reform under the Affordable Care Act include efforts to enhance the delivery of public health services that promote health and prevent disease and injury on a population-wide basis. The nation’s public health delivery system comprises nearly 3000 local public health agencies that vary widely in size, resources, and capabilities. Economic pressures, workforce shortages, and new national accreditation standards are leading these agencies to explore mechanisms for pooling resources and expertise across local jurisdictions to enhance delivery and improve population health. This analysis uses longitudinal observations on a national sample of local public health agencies …

Funding Public Health: A New Iom Report On Investing In A Healthier Future, George Isham, Robert Kaplan, Glen P. Mays

Health Management and Policy Presentations

A new Institute of Medicine report recommends establishing a national target for life expectancy and implementing new mechanisms for financing public health strategies to acheive this target.

Analisis Demand Dan Supply Konsumsi Garam Beryodium Tingkat Rumah Tangga, Nadia Irina Darmawan, Ede Surya Darmawan

Kesmas

Secara nasional, konsumsi garam beryodium cukup adalah 62,3% dan di Provinsi Jawa Barat adalah 58,3%. Cakupan konsumsi garam beryodium tingkat rumah tangga di Kota Bekasi hanya sekitar 62,14%. Pemantauan garam beryodium di tingkat rumah tangga oleh Dinas Kesehatan Kota Bekasi tahun 2004 menunjukkan bahwa garam yang mengandung yodium cukup adalah 51%. Penelitian ini dilakukan untuk mengetahui analisis faktor demand dan supply terhadap konsumsi garam beryodium tingkat rumah tangga di wilayah kerja Puskesmas Kecamatan Bekasi Barat Kota Bekasi dengan menggunakan desain cross sectional. Populasi yang diteliti yaitu 110 orang ibu dengan menggunakan uji chi square. Pada faktor demand didapatkan hasil bahwa …

Off Premises Sunday Sales In Georgia Localities: Will It Affect Traffic Accidents?, Forrest Rose, Nathan Dunkel

Georgia Journal of Public Policy

Discussions about public policy relating to alcohol cause a polarizing reaction to many people in this country, particularly in the South. The state of Georgia, for example, has a long history of policies regulating alcohol which reflects its membership as part of the “Bible Belt” where Sunday is regarded as a holy day and therefore alcohol cannot and should not be purchased on this day. Given that the impetus of alcohol control policy has generally widened the availability of alcohol since the Prohibition, the moral concerns of voters regarding alcohol regulation have been superseded in the public debate with safety …

Expanding The Evidence Base For Accreditation And Qi: Progress In Practice-Based Research Networks, Glen P. Mays

Health Management and Policy Presentations

Studies that examine the implementation and impact of quality improvement strategies in public health are underway through the Public Health Practice-Based Research Networks.

Estimating Medical Cost Offsets Attributable To Public Health Spending, Glen P. Mays

Health Management and Policy Presentations

BACKGROUND: Policy strategies for reforming the U.S. health care system to control costs and improve health outcomes include the possibility of expanded support for public health activities that are designed to prevent disease and promote health on a population-wide basis. These activities include efforts to monitor and report on community health status, investigate and control disease outbreaks, educate the public about health risks and prevention strategies, develop and enforce laws and regulations to protect health, and inspect and assure the safety and quality of water, food, air and other resources necessary for health. The Patient Protection and Affordable Care Act …

Canada Curbs Aboriginal Health Leadership, Paul C. Webster

Aboriginal Policy Research Consortium International (APRCi)

No abstract provided.

A Survey Of Seafood Traceability And Sustainability In The United States— Processes, Regulations, And Current Initiatives, Nancy A. Olsen

Working Papers

The global seafood industry currently lacks a standardized, widespread method to easily trace the chain of custody of products that they purchase. With global overfishing leading to declining fish stocks around the world, it is vital for seafood providers to have the ability to identify and buy products from sustainable fisheries that are well managed, target abundant species, and fish in environmentally responsible ways. This paper analyzes public and private initiatives that seek to provide product traceability. In summarizing the current status of seafood traceability, stakeholders agree that are a number of challenges with trying to piece together so many …

Reconsidering The Policy Options To Combat Obesity, Christine Ferguson

Health Policy and Management Faculty Posters and Presentations

No abstract provided.

Pillars For Progress On The Right To Health: Harnessing The Potential Of Human Rights Through A Framework Convention On Global Health, Eric A. Friedman, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Ever more constitutions incorporate the right to health, courts continue to expand their right to health jurisprudence, and communities and civil society increasingly turn to the right to health in their advocacy. Yet the right remains far from being realized. Even with steady progress on numerous fronts of global health, vast inequities at the global and national levels persist, and are responsible for millions of deaths annually. We propose a four-part approach to accelerating progress towards fulfilling the right to health: 1) national legal and policy reform, incorporating right to health obligations and principles including equity, participation, and accountability in …

Global Health Justice: A Perspective From The Global South On A Framework Convention On Global Health, Lawrence O. Gostin, Ames Dhai

Georgetown Law Faculty Publications and Other Works

A global coalition of civil society and academics recently launched the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI), which is developing a post-Millennium Development Goal (MDG) framework for global health. JALI’s mission is the achievement of a global health treaty based on the right to health—a Framework Convention on Global Health (FCGH). The FCGH proposes establishing fair terms of international co-operation, with agreed-upon mutually binding obligations to create enduring health system capacities, meet basic survival needs, and reduce unconscionable inequalities in global health. States that bear a disproportionate burden of disease have the least …

Co-Infected Diseases And State Health Policy: Botswana And South Africa's Response To Hiv And Tuberculosis, Margaret H. Schmidt

Lawrence University Honors Projects

The emergence of human immunodeficiency virus (HIV) has led to the growth of co-infection with other illnesses including tuberculosis. Many states are now attempting to address the problems presented with co-infected patients from a variety pathogens. In particular sub-Saharan Africa has suffered exponentially more from HIV and TB co-infection than other parts of the world. Thus, why have Botswana and South Africa not created national health policies to treat these diseases together? The following describes the process of how World Health Organization recommendations are translated into state policy. In turn, while donorship and international policy alterations create strong punctuations, the …

Surveillance Of Infectious Diseases Among American Indians And Alaska Natives, Jeanne Bertolli, Amy Roussel, Jennie Harris, Dan Lentine, Julia Gable, Ron Fichtner, Joann Kauffman, Michael Landen, Ralph T. Bryan

Journal of Health Disparities Research and Practice

We assessed participation in public health surveillance networks among Indian Health Service, tribal, and urban (I/T/U) Indian health facilities for a group of infectious diseases, and barriers to participation. We conducted surveys of I/T/U facilities and key informant interviews with representatives of tribal, urban, and national American Indian/Alaska Native (AI/AN) agencies. For the surveys, frequencies and percentages of responses in each response category were calculated. Qualitative methods were used to analyze interview content. The proportion of facilities participating in case reporting is suboptimal across facility types and diseases. Even when reporting is occurring, there is little feedback to tribal agencies. …

Gay And Lesbian Health Disparities: Evidence And Recommendations For Elimination, M. R. Barker

Journal of Health Disparities Research and Practice

Research suggests that significant health disparities exist among the gay and lesbian population in the United States. These disparities impact both the short- and long-term health outcomes of this population. This study first provides a current literature review of available research on gay and lesbian health disparities and organizes these findings according to health topic. The paper then investigates recommendations for the elimination of racial and ethnic health disparities and examines their applicability in eliminating sexual minority disparities. While many recommendations are valid, this paper analyzes the six thought to have the greatest potential in eliminating gay and lesbian health …

Evaluation Of Lift Up Your Voice! Advocacy Training For Older Adults And Their Caregivers: Executive Summary, Alison Gottlieb, Nina M. Silverstein, Kelli Barton

Gerontology Institute Publications

The Lift Up Your Voice! (LUYV) training, a component of Community Catalyst’s effort to support the Campaign for Better Care (CBC), is designed to mobilize grassroots advocacy structures of vulnerable older adults by directly engaging and empowering older adults and their caregivers. The goal of the evaluation is to assess the effectiveness LUYV in recruiting potential advocates, educating them about the health care reform, empowering them via advocacy skills training, and engaging them in state-based CBC activities.

Coordinating And Integrating Care For Safety Net Patients: Lessons From Six Communities, Leighton C. Ku, Marsha Regenstein, Peter Shin, Holly Mead, Alice R. Levy, Kate Buchanan, Fraser Rothenberg Byrne

Health Policy and Management Faculty Publications

This report examines efforts to improve the coordination of health care among safety net providers in six communities (Austin, TX; Brooklyn, NY; Indianapolis, IN; Marshfield, WI; San Francisco, CA; and St. Louis, MO), based on case study site visits and a roundtable discussion. Across the communities, we identified three approaches to improving coordination: (1) collaboration of providers using a coordinating organization, (2) coordination facilitated by Medicaid managed care plans, and (3) development of highly integrated care systems. These represent models that could be used by different communities, based on their local circumstances. Successful development of coordination approaches involved shared commitment …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

A Framework Convention On Global Health: Health For All, Justice For All, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Health inequalities represent perhaps the most consequential global health challenge and yet they persist despite increased funding and innovative programs. The United Nations is revising the Millennium Development Goals (MDGs) that will shape the world for many years to come. What would a transformative post-MDG framework for global health justice look like? A global coalition of civil society and academics—the Joint Action and Learning Initiative on National and Global Responsibilities for Health (JALI)—has formed an international campaign to advocate for a Framework Convention on Global Health (FCGH). Recently endorsed by the UN Secretary-General, the FCGH would reimagine global governance for …

The Science Of Public Health Practice: Using Pbrns For Delivery System Research In Public Health Settings, Glen P. Mays

Health Management and Policy Presentations

PBRN research tests strategies for improving the delivery of services that promote health and prevent disease and injury on a population-wide basis.

The Task Force Initiative: Local Interventions At The Department Level—A Key Component Of A Multi-Tiered Approach To Promote Institutional Change, Emily Conant, Patricia Scott, Josef Reum, Alyssa Westring, Susmita Pati, Lucy Tuton, Mary Sammel, Rebecca Speck, Jean Grisso, Stephanie Abbuhl

Health Policy and Management Faculty Posters and Presentations

This NIH Transforming Academic Culture (NIH-TAC) trial is a multi-level coordinated intervention to enhance institutional culture, increase academic productivity, and improve job satisfaction for women faculty. This poster details a task force initiative in which each department and division reviewed their current practices and policies to recommend and implement change. This particular task force resulted in a list of interventions which were disseminated and implemented throughout the institution.

Medicare: What Is In Store For Future Generations?, Karen L. Poon

Honors Scholar Theses

Medicare is the health insurance coverage provided to all senior citizens over the age of 65. It has been around since 1965. This paper takes an in-depth look into the Medicare program. First, the history behind Social Security is introduced. The Medicare program was created as an addition to Social Security, and its history follows. Although the ideas and goals of the Medicare program have good intentions, there are many issues with it. These problems are discussed in detail in the current issues portion of the paper. As a follow up, I have expanded upon and come up with some …