Respond to this discussion post..this was the original question….”
How can health policies be used as allocative or regulatory tools? Who are key stakeholders in any health policy debate? Financing for health care programs is always an issue. If a legislative body must finance health care using public funds, what types of taxes are the public most likely to accept and why?”
And this was a classmate respond. i just a response to the one below.
Health policies can be used as allocative tools by providing certain people or groups of people with resources to promote better health outcomes. For example, my husband is a nurse who works in an outpatient endocrine clinic. Part of his job is obtaining continuous glucose monitors for diabetic patients through Medicare/Medicaid; however, this is not always an easy task. There is a very stringent criteria to have one of these machines covered, for example, blood glucoses must be checked 4x/day, they need a special order for the monitor from their physician in addition to having a detailed written order form detailing why they need such device, and it can’t be filled at a regular pharmacy (i.e. must go through a mail order durable medical equipment pharmacy). While research has shown that continuous glucose monitoring improves glycemic control in diabetic patients, not everyone has access to a continuous glucose monitor or can get it covered by insurance (Triki et al., 2021). It would make sense for the government to cover this as preventative care measure as increased glycemic control can help prevent more expensive conditions related to diabetes (i.e. retinopathy, neuropathy, amputations, CV disease, kidney disease, strokes) and inpatient hospital, but this would also be a huge economic burden.
Most health policy bills are passed through our government; however, this is affected by lobbyists. Those against Medicare/Medicaid may not want their taxpayer money to help treat or prevent conditions that they do not individually suffer from. For example, if someone isn’t a diabetic, why should their taxpayer money pay for a continuous glucose monitor for someone who is? With that, it’s important for the public to view health as a shared value that needs to be promoted and protected as it can improve health outcomes and health equity (Chandra, et al., 2016). Medicare is a federally funded program, but often doesn’t include preventative care without jumping through many hoops. For example, physician visits often aren’t covered for pre diabetics, but are for someone who is already a diabetic.
Unfortunately, preventative care isn’t attainable for everyone. Sticking with the topic of diabetes, prevention can include a healthy diet, active lifestyle, and routine primary care check-ups—Not all people have access to this. In west Baltimore, healthy food options, even grocery stores, are not as readily available as they are in other nearby neighborhoods. This may lead individuals to be limited to unhealthy food options. Additionally, people may not have access to a gym, cannot afford a gym membership, or it may be too unsafe to exercise outside in their neighborhood. Also, individuals may not have the health literacy to understand preventative care when it comes to diabetes. It seems those in marginalized communities have the odds stacked against them—so should the government intervene? For example, should the government provide funding in areas such as West Baltimore where there are food deserts?
I think part of the issue with public funds is that if it doesn’t directly affect you, it is hard to understand why you need to pay for it. One way a legislative body can finance health care with public funds is by taxing individual items. An example of this is the Philly “Soda Tax”, which charges 1.5 cents per ounce on sweetened drinks with sugar or artificial sweeteners, (City of Philadelphia Government, 2021). The idea of taxing such beverages is to discourage people from wanting to purchase them if they are more expensive. Thus, reducing obesity and other related conditions such as diabetes in Americans. If people chose to make choices that are potentially unhealthy, they are individually being taxed rather than taxing everyone.
References
Chandra, A., Miller, C. E., Acosta, J. D., Weilant, S., Trujillo, M., & Plough, A. (2016). Drivers of health as a shared value: Mindset, expectations, sense of community, and civic engagement. Health Affairs, 35(11), 1959–1963. https://doi.org/10.1377/hlthaff.2016.0603
City of Philadelphia Government. (2021). Philadelphia Beverage Tax (PBT). Payments, assistance & taxes. Retrieved from https://www.phila.gov/services/payments-assistance-taxes/business-taxes/philadelphia-beverage-tax/
Triki, N., Yekutiel, N., Levi, L., & Azuri, J. (2021). The effects of continuous glucose monitoring system on patient outcomes and associated costs in a real‐world setting. Diabetic Medicine, 38(5). https://doi.org/10.1111/dme.14518
