Health Care Policy Process
The law and policymaking process is an essential aspect of national health care. Laws ensure that a standard is enumerated, thereby producing an established etiquette and professional expectations. Policies maintain the adaptability and relevancy of entities in operation. Yet these primary components of health care are compilations of contributions from federal, state, and local governments. Moreover, the U.S. Constitution gives clarity on the point of divide between the vertical tiers of government, (federal, state, local). Health care policymaking includes making authoritative decisions—but these decisions needn’t be despotic. Similarly, the Constitution’s Supremacy Clause found in Article VI ¶ 2 declares its authority over all other laws. Under the U.S. Constitution's Article VI ¶ 2 "This Constitution . . . shall be the supreme law of the land; and the judges in every state shall be bound thereby." America’s health care follows a similar approach; utilizing its “public policymaking structure” and “refer[ring] to the various branches of government and the individuals and the entities within each branch that play a role in making and implementing policy decisions,” (Teitelbaum, J., p. 13).
Black’s Law Dictionary defines the term Healthcare as “[c]ollectively, the services provided, usu. by medical professional, to maintain and restore health,” (Garner, B., p. 865). Bryan Garner notes that the term is “[a]lso written heath-care; health care,” (Garner, B., p. 865). Specifically, Garner defines the word Health as “[t]he quality, state, or condition of being sound or whole in body, mind, or soul; esp., freedom from pain or sickness. The relative quality, state, or condition of one’s physical or mental well-being,” (Garner, B., p. 865). Thus, health care is an extension of commonwealth—one of the fundamental purposes of government. But, like any power it must be decentralized; then spread throughout the vertical tiers of governance. There, it can be properly allocated throughout the states and localities to ensure that (1) no waste occurs; and (2) abuse is precluded without barring those who qualify.
The Vertical Tiers of Government
Federal. The federal government has the ability to enact national laws equally upon all states. But the federal government “does not have a monopoly on policymaking,” (Teitelbaum, J., p. 13). Under Article I of the U.S. Constitution “all legislative powers . . . granted [are] vested in a Congress;” namely the House of Representatives and the Senate. But, as witnessed and experienced during the SARS-CoV-2 coronavirus pandemic, blanket-policy is a catalyst for tyranny and despotic totalitarian iatrarchy. Thus, health care ought to originate from a local level. Administrative agencies are not legislatures; therefore should not be arbiters of any laws or regulations. The tendency for man to exploit any form of power is persistent; yet, worse is the potentiality of a faceless entity or organization to commit such atrocities. In a favorable light, statutes can be implemented to prevent administrative bureaucracies from exploiting the power of policy and attempting to fulfill their own agendas at the expense of the citizenry.
Another important aspect of federal health care is statutes. Some statutes “require private hospitals to provide needed emergency care without regard to ability to pay. Such statutes all stop well short, however, of creating an unlimited duty to serve all comers without compensation,” (Havighurst, C., p. 13). Here, administrative agencies are instrumental in health care policy. Accordingly, “administrative agencies can be created by statutes, internal department reorganization, or presidential directive,” (Teitelbaum, J., p. 23). Observably, “[p]residents are driven by multiple goals;” as the surplus of executive and independent agencies require the president to appoint “approximately 2,400 federal jobs,” (Teitelbaum, J., pp. 22, 23). But agencies require “statutory authority” to present any serious affects to any public policy issue; “agencies must have statutory authority in order to received appropriations from Congress and act with the force of law,” (Teitelbaum, J., p. 23).
One of the most important aspects of federal health policy is rejecting defaulting to a global health standard by having working policies; whilst denying foreign infiltration. The World Health Organization’s (WHO) constitution asks that its members default to its global health policy in the event of a health emergency. Global health organizations are not the arbiters of policy; as no action can be universally and culturally sound. Accordingly, “the WHO has struggled unsuccessfully to increase assessed contributions and thus to have more autonomy in setting its own priorities,” (Ceuto, M., p. 327). Their hand was shown during the SARS-CoV-2 coronavirus pandemic whereby tyrants colluded to exploit the afflicted, shut down the world, and enrich their own prosperity at whatever expense necessary. Thus spake the need for decentralizing the Leviathan and dismembering the iatrarchy.
Federal health laws must aptly adapt to the needs of the nation; these changes ought to be broad (and often are)—thus allowing for states to standardize the details of various health care provisions. Specifically, “[c]hanges in federal law in 1981 greatly increased the flexibility of states in controlling payments to hospitals under the Medicaid programs,” (Havighurst, C., p. 278). In this, “[t]he prospective reimbursement systems used by the states in paying for Medicaid inpatient hospital services vary considerably,” (Havighurst, C., p. 278). Joel Teitelbaum and Sara Wilensky note that Because statutes tend to be written as broad policy statements (and because words on a page can never communicate intent with absolute accuracy), there are few statutes that are utterly unambiguous, (Teitelbaum & Wilensky, p 37). Teitelbaum and Wilensky add that “[t]he fact that statutes are written in broad generalities has another consequence beyond their need to be interpreted and applied in vast numbers of unique instances: specific regulations must be written to assist with the implementation of statutory directives and to promote statutes’ underlying policy goals,” (Teitelbaum & Wilensky, p 37).
State. Any action that does not conflict with the enumerated properties of the national government; is a decision left to the states. Under the Tenth Amendment; “[t]he powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.” Thus, states are free to conduct themselves in a manner best suited to represent the needs of their constituency. States are dutied to “regulate provider licensing, accreditation, some aspects of health insurance, and most public health concerns,” (Teitelbaum & Wilensky, p.12). Joel B. Teitelbaum and Sara Wilensky note that additionally, “[s]tate legislatures pass laws, appropriate money within the state, and conduct oversight of state programs and agencies. States also have their own judiciary with trial and appellate courts,” (Teitelbaum, J., p.12). State initatives are achieved through “[t]he governor [elected as] the head of the state executive branch and can set policy, appoint cabinet members, and use state administrative agencies to issue regulations that implement state laws,” (Teitelbaum & Wilensky, p.12).
States are left to implement novel regulations when it comes to new technology; depending on their success, these endeavors may be adapted in national policy. One example is with the recent emergence of 5G technology. The National Conference of State Legislatures (NCSL) noted in October 2022 that “[m]ore than 30 state legislatures have enacted small cell legislation that streamlines regulations to facilitate the deployment of 5G small cells,” (NCSL). Yet, while New York City’s bold legislation holds that it “[p]rohibits the placement of fifth generation (5G) telecommunications towers within 250 feet of a business or residence in cities with a population of one million or more” it is conditional to attaining “the owner's consent,” and “community board approval,” (NYSenate). Thus, while citizens may feel secure in knowing that some protections exist, a consenting owner removes any policy barrier between the 5G tower and the citizen. Visible 5G towers exist atop the residential buildings throughout neighborhoods in Brooklyn, placing tenants who live on the top floor in arms' length of the 5G radiation.
Local. Local governments bear a representative role in health care policy. Every state is divided into districts comprised of various stakeholders; theses include “patients, healthcare providers, governments and the public,” alongside “[m]anaged care and traditional insurance companies, employers, private healthcare industries, the research community, [and] interest groups,” (Teitelbaum & Wilensky, p. 7). Locally, “[e]ach hospital has a unique case-mix index (CMI), reflecting the severity of the condition of its average Medicare patient,” (Havighurst, C., p. 234). Under the Ninth Amendment; “[t]he enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.” Therefore, local communities may formulate their own standards representative to the needs of their citizenry. National policy caters to the majority, neglecting advocates of minoritarian initiatives. Citizens remain obligated to steward their autonomy; “just because a problem is identified as a public policy [issue] does not necessarily mean the only solution involves government intervention,” (Teitelbaum & Wilensky, p. 12). Dr. Jeff Myers, president of Summit Ministries reminds us that “[b]y definition, every government transaction is a third-party payer transaction;” with third-party transactions, “you don’t have to pay for the item, nor do you have to use it. You don’t care how high the price is because you’re not paying. Nor do you care whether the quality is low, because you’re not using it,” (SummitMinistries). Concisely, government is unalive—unable to distribute pathos. Humans need other humans; governments are not humans; thus, governments are bodies of power created to formulate law.
Concisely, sometimes the best form of public policy is an absence of regulations; thus limited government. As experienced in major cities during the coronavirus pandemic, the solution was government-mandated lockdowns; forced vaccination in order to gain access to public resources; and reconfiguring society to comply with excessive regulations—including building outdoor structures, tents, and heaters to move businesses outdoors. Local governments aligned themselves with State governments who followed the national government—who sought advice from the global health organizations. The result was unlike anything experienced in contemporary American history. The mishandling of the pandemic exemplified the need for civic sovereignty and the recognition of individual rights. Robert F. Kennedy, Jr., writes that the tried “approach to ending an infectious disease contagion had no public health precedent and anemic scientific support,” (Kennedy, Jr., R., p. 53). Worse, “[m]ost medicinal products cannot get licensed without first undergoing randomized placebo-controlled trials that compare health outcomes—including all-cause mortalities—in medicated versus unmedicated cohorts,” (Kennedy, Jr., R., pp. 753, 754). Instead, the government forcibly mass injected experimental concoctions into the entire population; then spread this profitable venture unto the world. Now, the majority of citizens in every nation have injected the unknown substances. SM-102 is one example of a toxic substance used as a synthetic nanoparticle in Moderna mRNA concoctions. Cayman Chemicals notes a strict “WARNING” writing “[t]his product is not for human or veterinary use,” (CaymanChemicals). BroadPharm, A Worldwide Leading PEG Supplier writes that SM-102 is . . . used for the delivery of mRNA-based COVID-19 vaccines; noting that it is “for research use only,” (BroadPharm). Mount Sinai confirms in a detailed breakdown of the vaccine’s ingredients that SM-102 is included “proprietary to Moderna,” (MountSinai). No man ought to forcibly injected with experimental substances to further research on new biotechnology; whilst normalizing the usage of mRNA. Rather than adjust a public problem, the national government utilized the pandemic as an opportunity to co-labor with major pharmaceutical enterprises to (1) conduct mass experiments with new biotechnology; (2) depose the working-class, exterminate small businesses, and (3) disrupt the free market. The result has been the decimation of the nation’s greatest cities; specifically as witnessed and experienced from living in New York City.
Conceptualizing health policy and law, one framework notes that “self-interest will lead to autonomous physicians [driving] up the cost of their services” and conversely that “public insurance programs like Medicare would lead individuals to seek unnecessary care,” (Teitelbaum & Wilensky, p. 7). Clark C. Havighurst notes that “[a]lthough the shift to fixed payment by diagnosis was intended to induce economizing, it might also induce profiteering at the expense of patient welfare,” (Havighurst, C., p. 235). Havighurst concludes that “[a]buse is, unfortunately, often in the eye of the beholder,” (Havighurst, C., p. 235).
Thus, a free market perspective of self-autonomy, through “commercial competition and consumer empowerment will lead to the cost efficient healthcare system,” (Teitelbaum & Wilensky, p. 6). It is the duty of the individual to not seek unnecessary care; especially those opting to obtain financial assistance rather than work a mundane job for minimum wage. Although the job brings little to no money—it is capable of paying the bills, and allowing for time to attain a degree, start a business, or follow some other light at the end of the tunnel; rather than fall into stagnant servitude, and contribute to the weakening of the collective morale. Political theorist Alex Jones of Infowars.com writes that “The life force is so powerful that we, as biological organisms, can put up with a lot. God has endowed His creatures with magnificent feedback systems to address the challenges they might face, (Jones, A., p. 70). Through union—not division—the citizenry can better steward the relevancy of the system.
Biblical Context
Dr. Jeff Myers adds “I believe a government-run healthcare system fails in both compassion and stewardship. Governments don’t have the ability to be compassionate—they only have the power to coerce some people to solve problems for others, either through taxes or penalties,” (SummitMinistries, p. 4). Dr. Meyers reminds us that “Christians are the ones who started hospitals . . . who established our system of modern science from which health care came . . . [thus] Christians should be involved in helping provide high quality, low cost care to those in need,” (SummitMinistiries, p. 3). Jesus reminds us in the New Testament “[i]t is not the healthy who need a doctor, but the sick. But go and learn what this means: ‘I desire mercy, not sacrifice.’ For I have not come to call the righteous, but sinners,” (Matthew 9:11b-13; NIV). Christians ought not to remain secluded within the Church, but address the needs of the community as Jesus would have done without judgment. This includes refusing to self-censor Christian views so long as they are not personal attacks that would otherwise violate the doctrine itself. God reminds us a vital daily maxim unto ourselves; that "[i]f I testify about myself, my testimony is not true. There is another who testifies in my favor, and I know that his testimony about me is true. (John 5:31, 32; NIV). Both internal and external judgment needn't occur in a manner that exceeds one's personal conduct and self-regulation as witnessed unto the public.
As Dr. Meyers concludes, “Christians must be involved. We must be compassionate. We must be good stewards,” (SummitMinistries, p. 6). Thus, the landscape of pluralism is the contemporary Christian mission; therefore it is the obligation of the citizenry to steward the sovereignty without calling for government intervention. This is no easy task; but every man is inherently endowed with the ability to remedy any obstacle that strives to inhibit the intent of God’s Kingdom. Jesus reminds the obligation of the Christian: no matter the circumstance, man must place effort to align his mind in a manner that invokes His Holy Spirit; thereby distributing God's abundance unto the world. "Jesus answered his critics by saying, 'Every day my Father is at work, and I will be, too!'" (John 5:17; TPT) This work needn't solely be physical, but spiritual; in that joy must supplant cynicism—specifically when making health care policy.
Conclusion
As the government is federally divided in its power to preclude tyranny; so is America’s health care system, when enacting laws and making relevant policies. The local government is responsible for the transmission of data to the state that ascends to the national level where each Medicare program is considered for its appropriation; assisting in the prevention of exploitation. But that does not stop man’s propensity for sin; whereby riders will opt for government intervention rather than contribute to a collective autonomy. Health care policy making is an essential practice whose necessity outweighs the potential for its abuse. Thus, it is important that every level of its existence is considered at a local level; and officious national demands are rejected. National policy ought to be broad, not specific; local policy is meant to cater to the interests of the constituency—therefore requires more specific standards be enumerated within its locality. Regionally, every state can interpret the broader federal regulations; allowing for various counties and metropolises to make their own decisions depending on the needs of the community; rather than invoking despotic blanket policy. Health care ought to extend to civic morale and individual morality, as both are essential to its posterity within this exceptional Constitutional Republic.
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