How Political Systems & Leaders Affect Health Care Policy

Instructor: Ann Kearney

Annie has a Doctorate in Health Education and Promotion. She has taught a variety of levels and has lectured at the University level in both the USA and the UK.

In this lesson, you'll learn how political systems and leaders affect health care policy. We'll explore effective development and implementation. We'll also look at a current example of a health care debate and the views of two government parties.

Political Systems and Leaders Develop and Implement Health Policy

Planned parenthood debates, health care debates, and public school meal debates. Have you ever wondered why these topics are so debatable or what influence our elected leaders have on these debates? Well, policy comes to order through political systems, and the development and implementation of health policy comes from political leaders.

A successful leader of health policy will have strategic vision, technical knowledge, political skills, and strong ethics, translating health needs into effective policy that is in the best interest of all citizens. Let's look at two types of government leadership: authoritative and democratic.

Authoritative Government

In an authoritative government, the leader makes all the decisions regarding policies and procedures; there is line of demarcation between the leader and the followers. The government is centralized and task oriented. An authoritative government can be broken in different ways.

In a totalitarian dictatorship the government is ruled by one person. An example of a totalitarian dictator was Adolph Hitler. In an absolute monarchy the king, queen or emperor is the ultimate ruler. An example is Saudi Arabia.

How an Authoritative Government Delivers Health Care

It's important to remember that an authoritative government can operate on a spectrum, with some leaders holding more power than others. In an extremely authoritative government, there may or may not be elections, there is little contact with citizens and the citizens do not have a voice in the leader's decisions.

While authoritative governments might sound off-putting, they can also be effective, including when it comes to health. For example, Cuba, while a very poor country, considers health care to be a human right for all citizens, focusing on prevention, primary care and other services. The country's national health service and delivery system has shown that health care does not need to be massive financial investment.

Democratic Government

In a democratic government, the leader takes consultation on different matters and shares decision-making powers and other responsibilities with members of the government. Members should be experienced and qualified, and the suggestions and opinions of the people they represent are given importance. Democratic governments are decentralized and relation oriented.

While on a spectrum for how democratic they are, Iceland and the United States are led with a democratic government.

How a Democratic Government Delivers Health Care

It's important to remember that the United States, a democratic government, delivers health care through its political systems. You may think that all the decisions are coming from the White House, and yes, a lot of the big decisions are made there. But it is important to remember that state and town governments also have elected officials who implement health care decisions.

  1. At the national level there are three branches of government: judicial, executive (led by the president) and legislative. These branches seek advice and guidance from health research organizations, such as the CDC (Center for Disease Control) and NIH (National Institute of Health).

  2. At the state level there are also three branches: judicial, executive (led by the governor) and legislative.

Town or cities also have elected officials who lead the town in health care implementation. Finally, neighborhoods might have committees and teams that implement health care.

The United States runs as a democratic leadership; we vote our leaders into power.

How the U.S. Compares to Other Countries

The last time the World Health Organization released the rankings of the world's health systems was in 2000. During this ranking the U.S. was ranked #37, behind smaller countries such as Singapore. France and Italy took the #1 and #2 spots, respectively. There is numerous evidence and smaller research projects that show the U.S., while one of the most powerful and richest countries in the world, has poor health care systems and overall population health. This is in spite of the significant funds spent on health care in the U.S.

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