Historical Overview of Public health policy
The foundation that supports the delivery of health services and practices as its infrastructure is among federal, state and local is defined as public health. Public health delivers services and functions among 300 counties and cities health departments within the 59 state and territorial public health agencies, federal agencies, network of health laboratories and other private and public organizations (Honore, 2003). Communicable disease preventions, environmental health, family health, maternal child, laboratory services, health facility regulations and licensure, chronic disease prevention, emergency preparedness are some of the functions of the public health services. Additional public health programs are offered at the state level such as community assessment, immunization, safety inspection, educations and community outreach. Three core functions of public health are identified as policy development, assessment, and assurance. These three core functions are further divided into ten activities such as; monitor health status and identify health problems, assessment, diagnose and investigate health hazards and problems to the community, policy development, educate, inform and empower people about health issues, mobile community partnership, and identify and solve health problems, enforce laws and regulations that protect health and ensure safety, assure the provision of care when otherwise unavailable, Assure a competent public health and personal health care workforce, Evaluate effectiveness, accessibility, and quality of personal and population-based health services and Research for new insights and innovative solutions to health problems (Honore, 2003). The activities performed to carry out these functions are identified as, investigate, assess, advocate, analyze, plan, prioritize, implement, manage, evaluate and educate. Public health jurisdiction participates with state health departments through outside agencies such as medical clinics, hospitals physicians, community and migrant health centers, non-profit organizations, universities government agencies and other institutes.
National health expenditure in federal capacity have not really gone into the public health infrastructure rather spent on constructions projects and biomedical research in support of the medical care delivery system. Financing of the health infrastructure for delivery of public health is done at the state level. It is identified that serious macro-level problems because of the absence of guidelines on investment requirements and financing options to ensure a structurally sound public health system. There are no funding formulas for public health financial analysis and management in place for additional funding for the public health infrastructure. Public health does not have institutionalized standards and routine practices that supports micro level problems. When measuring performance, financial stability is one important area to consider. Research must develop standard systems in public health as it has been noted that there are unresolved problems such as, lack of knowledge on national funding requirement and lack of comprehensive investment plans with clear performance measures, lack of reporting to advise the DHSS about financing that affects governmental public health and lack of systems of accountability to ensure quality and availability of public health. The Centre for Decease Control (CDC) has created a public health finance program dedicated to analyzing and research public funding. The programs that investigate funding patterns have been identified by a subsequent research. An analysis of public health finance problems has opened more questions than solutions to the problem. Limited knowledge of financial data from the practitioners, create difficulty in getting a good understanding of public health finance problem. Identifying the responsible parties are the duty of public health systems. Lack of public health database and inconsistency in the categorization of health expenditure are reasons two problems identified in public health finance. Generally, public health financial data are obtained by researchers by the Center for Medicaid and Medicare Services (CMS) (Honore, 2003). The published information through has not been utilized to with programs and by expenditure categories for federal grant reporting purposes. The President’s Management Agenda (PMA) called for financial information to identify cost and benefits (Honore, 2003). Timely and reliable financial information which trickle down to local and state level determines the effectiveness of local agencies. Essential services such as National Association of City and County Health Officials (NACCHO), Public Health Foundation (PHF) and Association of State and Territorial Health collect information of estimate expenditure data into specific functional categories developed to present a framework of public health infrastructure. A comparable degree of financial analysis should be carried out with consistent and valid data to proceed with the public health finance. The best practices of an organization improve the financial strength of the organization. Continuous system process to evaluate products and services and the process of work represent the best practices of an organization.
Health decisions of the public
People maximize their satisfaction when considering the purchase of health-related products such as health insurance. Purchase decisions may be made subject to income available to make purchases. Consumers make choices on healthcare production, distribution, and consumption of health resources such as health providers, hospitals, physician offices, pharmacies prescription drugs, and diagnostic centers etc. A scarcity of healthcare resources exists due to inability to produce health goods and personnel to meet the demand of the entire population. Due to this reason, tradeoffs and choices must be made in making health care choices. Consumer choices are based on individual preferences and efficiency In the distribution of resources, there will be someone better, competitively to someone worse. The efficiency is referred to as Pareto efficiency which includes production efficiency, allocative efficiency and technical efficiency which involves the cost of goods and services (Teitelbaum, 2013). Reducing the cost of the inputs used to produce goods and services (Production efficiency), providing the most value for the goods and services (allocative efficiency) and using the least amount of inputs to create goods and service (technical efficiency) are the efficiencies involve in making health decisions. When producing goods and services, the organizations should produce goods and services in a less costly setting to be competitive in the market (Teitelbaum, 2013). The Patient Protection and Affordable Care Act was enacted to create healthcare transformation and ensure that Americans have access to affordable and quality healthcare within the health systems.