PUBH 102 Lecture 4: Health Laws, Policy Ethics, and Social Justice

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UNIQUE FEATURES OF PUBLIC HEALTH
Social justice perspective
Inherently political
Evolving expectations leading to expanding agenda
Link w/ government
Grounding in science
Focus on prevention
Uncommon culture
COMPONENTS OF HEATLH LAW, POLICY, AND ETHICS
Health care falls under scope of access, quality, and cost of health; organizational
and professional structures for delivery of care
o Ex. Rules governing medicare and medicaid, as well as laws governing
private insurance; hospital governance and professional license
Public health falls under scope of population health and safety, including
governmental efforts to provide services to entire populations, as well as vulnerable
groups
o Ex. Food and drug laws and procedures, environmental laws and procedures,
regulations for control of communicable diseases
Bioethics falls under scope of application of individual and group values and morals
to controversial areas
o Ex. End-of-life care, stem cell research, abortion, protection of research
subjects
AMERICAN GOV AND PUBLIC HEALTH
Federalism means there's shared responsibility among national and tribal
components
Federalism and public health
o "health" hard to find in US constitution
o Relative roles of national, state, and local governments in health matters shift
over time
o Social values shift over time
3 BRANCHES OF US GOV
Legislative (makes laws)
o Congress
Senate and house of reps
Judicial (evaluates laws)
o Supreme court and other federal courts
Executive (carries out laws)
o President
Vice president and cabinet
TYPES OF US LAW
Diff sources of law
o Constitutionally based law
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Comes from the constitution, but can make amendments
o Legislatively based law
o Administrative law
o Judicially based law
Comes from past experiences/ decisions
Purposes for PH laws
o Protect and promote health (police and general welfare powers)
o Ensure rights of individuals
PUBLIC HEALTH LAW
Public health law- the state's legal powers and duties, in collaboration with its
partners, to ensure the conditions for people to be healthy, and limits on the state's
power to constrain individual rights
o PH pursues high levels of health, consistent with social justice
Affected by:
o State's police power and limits
Coercive measures to protect the public's health, balanced with respect
for individual rights
o Partners
The "Public Health System," comprising health care, business, the
community, media, and academe
o Populations
Shared-risk, large-scale interventions to protect the community's health
and well-being
o Communities
Healthy social interactions, mutual support, and civic participation
o Prevention
Interventions to reduce risk or overt harm from injury/disease
o Social justice
Fair and equitable treatment of groups and individuals, with particular
attention to the disadvantaged
o Government
Power and duty to protect the public's health and safety
HOW DOES A BILL BECOME A LAW
Starts at congress and then introduced to house and senate
In the house:
o Bill is referred to House committee or subcommittee
o Committee marks up the bill with changes
o Voted on by full committee
o Committee reports and Bill is put on House calendar
o House reading and debate; amendments are added
o House full vote
In the senate:
o Bill is referred to senate committee or subcommittee
o Committee marks up bill with changes
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