Politics and economic interests are among the key determinants of population health with significant influence on health policy. Many critical forces shaping healthcare in the U.S. have more to do with political and economic policy than any other particular process or procedure. For example, politics identifies and addresses a wide range of health challenges, leading to the development of health-related policies. From an economic point of view, factors such as income inequalities, strong labor movements, and full employment policies shape the development of health policies. Thus, politics and economic interests play a vital role in shaping health and healthcare policies in the US.
The Influence of Economic Interests on the Development and Direction of Health Policy
One of the economic factors that shape health policies is strong labor movements. If the labor movements are powerful, they lead to better working conditions for workers (Swain, 2016). Furthermore, working conditions contribute to health outcomes. Better working conditions are related to fewer occupational diseases, disorders related to chemical exposure, and accidents in the workplace. In response to poor working conditions, health policies to build healthy and happy working environment are developed. In addition, polities that improve work-life balance emerge to respond to the poor working conditions. Full employment policies accommodating a higher percentage of women in the labor market contribute to well-being, particularly women’s health. Studies point to the protective effect of employment on women’s health since the incthe ome earned provides women with some level of economic independence and enhances their purchasing power. In addition, the good work environment offers women a chance to build their confidence, decision-making, and self-esteem that makes life more satisfying. Since women bring new set of skills to the labor market, policies are developed to improve their productivity. For example, policies to keep women physically fit more often are prioritized.
Income inequality is another economic factor that plays a critical role in shaping health policies. Inequalities in income are related to poor health outcomes since they increase poverty prevalence. In addition, income inequalities contribute to chronic stress because of increased social comparisons. The inequalities further erode societal cohesion and destabilize institutions that protect healthcare. Greater economic inequalities lead to worse health outcomes for even the affluent since the inequalities reduce social cohesion and cause more fear, stress, and insecurity for all (Longest, 2016). For example, the racial disparities in the distribution of COVID-19 vaccines have led to a decline in life expectancy for black Americans. The pandemic further made transgender Americans vulnerable and at a higher risk of contracting COVID-19. One of the reasons behind this trend is that transgender Americans and people of color are more likely to be low-income earners compared to the general US population. People living in extremely poor conditions are more likely to live shorter lives because the higher the level of income inequalities, the higher the rate of deaths. The US is ranked at the extreme end, with a wider gap between the rich and the poor. According to Swain (2016), the rate of mortality rate is also considerably higher at 5.7 per 1,000 births. Due to these detrimental effects of income inequalities, policies to bridge the inequality gap have been initiated. For example, programs to redistribute wealth and make it easier for the poor to improve their economic status have emerge in the US. Further to this incentives and tax holidays are advanced to the low income earners to achieve economic equality. Thus, economic policies have been created to respond to the negative effects of income inequalities.
The Influence of Politics on the Development and Direction of Health Policy
Politics also play a key role in shaping health affairs as well as determining how policymakers acknowledge and address the existing problems. In the US, politics is used to facilitate certain public health interventions as well as to oversee policy implementation (Greer, et al., 2018). consequently, public health professionals must understand the political dimension of the underlying problems as well as the proposed solutions regardless of whether they hold government positions or other advocacy group positions in the healthcare industry. Public health mainly relies on governmental support to yield positive outcomes. Whether it is health promotion or prevention of diseases that the population cannot achieve by itself, political intervention is inevitable. Gains in the public health sector are only achieved through collective action as opposed to individual contributions. Additionally, institutional actions produce a greater spillover effect, a phenomenon referred to as externalities in economics (Fischer & Miller, 2017). While some externalities are harmful, some are extremely beneficial to the general public. For example, politics influence policies related to private actions such as vaccinations, smoking, sexual practices, and driving when intoxicated. Politics also regulate the production and sale of certain products that need political decisions as to how and when to consume or use them.
Politics is further used to identify and address a wide range of physical, economic, and psychological needs that go beyond the means of survival. In addition, protecting public health requires moral judgments that are only legitimized through resolutions and political debates. The US government, for example, is traditionally known for regulating public behavior such as abortion, assisted suicide, marijuana smoking, access to contraceptives, and other moral issues that are controversial and highly contested in the political landscape (Greer, et al., 2018). Moreover, a healthy workforce is crucial for social order and economic growth. For example, threats such as terrorism and pandemics like AIDs and COVID-19 are not only public health issues but also threats to national security, so they have the potential to cause political instability. Thus, politics shapes health policy mainly by regulating the public behavior.
From policy makers’ point of view, problems are those conditions that the population find unacceptable, so they need to be changed. Translating health issues into political problems occurs when the general public recognizes that their needs are communally shared with others and require interest group mobilization and political opinion (Gordon & SABIN, 2005). The way the government responds is based on how the problem is identified and defined. Problems can be identified and defined through a range of mechanisms, some of which are common while others are unpredictable. For example, policy debates emerge in response to a performance gap, crisis, from forecasting, or through comparison with other sectors or jurisdictions. The gaps can be self-evident to everyone or they can be established via statistical measures, scientific research, or even through examination of the existing programs. The responsiveness of the political class to a health issue, however, depends on factors such as the level of perceived risk as well as who is held responsible for the prevailing problem.
Historical Example
Children’s Health Insurance Program (CHIP) is a classic example how economic interests and politics influence the development of health policy. The policy was developed in 1997 through a political process with the aim of providing health coverage to children from low-income households (Haley et al., 2017). CHIP was developed through the Balanced Budget Act 1997. Since the Children’s Health Insurance Program was enacted, the number of children without health insurance in the US has reduced significantly to less than 5 million children (Haley et al., 2017). The program is jointly funded by State and federal governments using a formula provided by the Medicaid Federal Medical Assistance Percentage (FMAP).
Conclusion
Overall, Politics and economic interests are key factors that influence and shape health policy in the U.S. Economic factors like income inequalities, strong labor movements, and full employment policies play a critical role in the development of health policies. Politics is further used to identify and satisfy a wide range of health needs, leading to the development of health-related policies. Besides the ACA, the Children’s Health Insurance Program (CHIP) is one of the historical examples of health policies developed through a political process.
References
Fischer, F., & Miller, G. J. (Eds.). (2017). Handbook of public policy analysis: theory, politics, and methods. Routledge.
Gordon, C., & SABIN, L. E. (2005). Dead on Arrival: The Politics of Health-Care in Twentieth Century America.
Greer, S. L., Bekker, M. P., Azzopardi-Muscat, N., & McKee, M. (2018). Political analysis in public health: middle-range concepts to make sense of the politics of health. European journal of public health, 28(suppl_3), 3-6.
Haley, J., Wang, R., Buettgens, M., & Kenney, G. M. (2017). Health insurance coverage among children ages 3 and younger and their parents.
Longest, B. B. (2016). Health policymaking in the United States. Ann Arbor, Mich: AUPHA Press/Health Administration Press.
Swain, G. R. (2016). How does economic and social disadvantage affect health. Focus, 33(1), 1-6.
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