Effects of Policy on Healthcare
By Monica Gonzalez and Krish Ajmani
Thousands of individuals foster anger at insurance companies and big pharmaceutical companies. This animosity arises from the perceived ability of these sectors to set their own agendas and from the powerlessness citizens feel in controlling their own health outcomes. Open discussion, however, provides a useful avenue that people can use not just to express their opinion to others, but also to enact change as they see fit. While the pandemic and its effects have been discussed ad nauseam, it continues to serve as a fascinating case study of the intersection of healthcare with a field that few associate with it: public policy and legislation.
The government was put into a position that required it to make quick and often unpopular decisions for the good of the public. The political system works best when constant feedback from citizens makes its way to policymakers, with the latter making decisions to keep the former happy and healthy. Examples of the political machine being used for the benefit of residents are plentiful. Only looking back a few years, the passage of the Affordable Care Act signaled how legislation can be used to protect individuals. Throughout the COVID-19 pandemic, mask mandates were passed, along with stimulus checks to protect the livelihoods of hundreds of thousands of struggling citizens. Once again, government officials respond to the concerns raised by those who voted them into office. While public policy and legislation can have crucial effects within a country, they also have the potential to influence matters on an international scale.
Organizations such as the World Health Organization (WHO) are integral to coordinating the responses of multiple nations while they, among other groups, provide supplies, training and information to those who need it. The stance of individual countries can also signal their priorities and reaffirm that diseases do not stay within borders; they spread rapidly and can affect people from dozens of other nations. International travel and globalization only exacerbate the proliferation of disease.
An international health crisis where organizations like the WHO, United Nations Programme, and others allocated funds to provide treatment to individuals globally was HIV/AIDS. New international health policies were established to assist people living with AIDS in lower and middle-income countries. The health policy, policymakers, and organizations developed made treatment more accessible, alleviating the number of deaths due to AIDS.
Throughout the 1900s, the initial perception of HIV/AIDS was thought to be only affecting certain individuals as a punishment for engaging in homosexuality. Social factors like religion played a role in the way HIV/AIDS was viewed. While the policy was in place, social theories like neoliberalism promoted privatizing medicine. Because medicine was privatized, prices were harder to regulate and control. This included the HIV/AIDS treatment, HAART. HAART was purposefully made “expensive” which made it inaccessible to people in Africa who were dying of AIDS. Politicians and organizations gave the impression of there being a scarcity of resources and limiting the access to HAART by selecting certain individuals in Africa who “qualified” for the treatments. [2]
Social movements, activism, and policy were key factors that prompted a change. HIV/AIDS was the global focus and prompted activists to apply pressure and be critical of the initial response to this health crisis. The HIV/AIDS crisis allowed for global health policies to reframe their approach and redefine the possible. The impact that the HIV/AIDS crisis had on global health policy was a positive impact by being critical of the decisions made and allowing for more equity.
U.S.-centered policies, like Roe v. Wade, continue to shape reproductive health outcomes. For example, the Turnaway Study conducted by researchers at the University of San Francisco explores the consequences of denying women an abortion. This study found that women who were denied an abortion were more likely to experience more complications and death at the end of their pregnancy, stay with an abusive partner, suffer from anxiety, poor mental health, and serious implications for the child born of unwanted pregnancy. Reproductive health rights, specifically abortion bans continue to be a topic of discussion in the U.S. and globally. [1]
Public policy changes can certainly alter healthcare outcomes and can help address various health issues, globally and locally. Policies influence health drivers like health behaviors, clinical care, physical environment, social and economic environment, which not only target individuals but populations or countries as a whole. [3]
Sources:
[1] Implementing a prospective study of women seeking abortion in the United States: understanding and overcoming barriers to recruitment (Dobkin et al.)
[2] Redefining the Possible: The Global AIDS Response (Messac and Prabhu)
[3] 5 Ways Public Policy Impacts Health (Pellegrin)
Monica Gonzalez is a fourth-year Biological Sciences major at UCLA. Krish Ajmani is a third-year Psychobiology major at UCLA. Monica and Krish are both THINQ 2021–2022 clinical fellows.
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