Introduction: The History, Policies, and Structures That Shape Health Care Regulation
Introduction: The History, Policies, and Structures That Shape Health Care Regulation
This chapter presents background on the nature of health policy and the role of regulation in translating policy into action. It describes the fundamental policy goals of improving quality, enhancing access, and controlling costs and the ways in which they compete, as improvements in one goal inevitably harm one or both of the others. Over the course of the 20th century, the primary emphasis of most new regulatory initiatives evolved from quality to access to cost. The chapter then explains the process of regulation and the legal rules for governmental regulatory agencies, particularly the federal Administrative Procedures Act. It also describes the basic structure of the largest regulatory body of all, the Federal Department of Health and Human Services. It concludes with a discussion of perennial policy conflicts, including the balance between regulation and market forces, between private and governmental regulation, and between state and federal primacy in regulation.
Keywords: health care cost, health care quality, health care access, administrative procedure, Department of Health and Human Services, government
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