Take One or the Collection of the Models Explained in the Lecture and Put It in a Situation: Healthcare Assignment, NUS, Singapore

Assignment Task:

Take one or the collection of the models explained in the lecture and put it in a situation where you have to explain it as a Memo. Then choose any provider of health care policy anything in the Affordable Care Act and use one of the 3 Models (explained in the lecture) to explain how that policy was created and who is influencing it and what it’s likely direction is going to be?

The Political Face of Public Health

ABSTRACT

Public health is politically paradoxical because its core conceptual components – the exercise of public authority and the promotion of population health – stand in practical tension that belies their theoretical promise. Across Western nations, public policymakers stand accused of failing properly to honour and support the crucial contributions that public health makes to the improvement of health outcomes and of overinvesting in acute medical care services, the need for which timely interventions in prevention and health promotion might have averted.

The dramatic budgetary discrepancies in Western nations between the massive funds devoted to medical care and the minuscule sums allotted to public health are often taken as evidence that in such matters, political leaders are irrational (or perhaps uninformed, or captured by big-moneyed medical interests) and that good public policy would have epidemiologists and other public health experts running, or at least orchestrating the show.

This paper explores the sources of this tension between population health and political power within the concept of public health and seeks to show why these strains prove to be so durable, indeed irresolvable. The argument and evidence draw largely on the United States, but the supposition – anyway, the hope – is that the analysis will also throw light on the politics of public health in other nations.

Key Words: Public Health, public policy, political power, health reform

INTRODUCTION: TWO DIFFERENT WORLDS

“Oh life, life, remaining always outside.” Rainer Maria Rilke

In 1966, Herbert Kaufman, a political scientist then at Yale University, surveyed the literature on the politics of public health and bewailed the barren scene. The public health profession tended to view itself as an evidence-based calling that stood above and beyond politics, while political scientists were slow to see how public health agencies and programs illuminated central disciplinary preoccupations such as budget making, recruitment of personnel, and the influence of constituencies on the performance of public agencies. Not a single public health text that Kaufman reviewed “included anything more than a passing reference to politics, and most… did not contain even that.” Conversely, the political science texts he surveyed contained “virtually no references to the politics of public programs.”