Effectiveness and Accountability Policy Modification

In the United States, health care is provided by many discrete organizations. The private sector business owns the largest portion of the health care facilities. Laws and policies have been enacted to protect health related issues of the Americans. In March 2010, president Obama agreed to sign an all-inclusive health reform. The Affordable Care Act (ACA) makes defensive care that has facilitated family planning and associated services more accessible and reasonably priced to Americans. The consumer is protected against insurance health policies that restricted validity period and those that regulated annual limits. . However, the act was faced by certain challenges. Twenty-six states in the U.S. were against this act and filed a lawsuit against the government.[1]

It is important to be able to distinguish policy initiation from policy modification. Policy initiation results from a rise in problems and possible solutions. All policies are subject to amendments. Jonas and Kovner stated that various initiatives have been put in place by the U.S. and other countries so that they can measure comparative effectiveness.[2] Policy modification results from existing policies that need legislation changes. The first stage is incremental. This stage allows time for adjustments and creates negligible disturbances and alterations. This stage also allows the government to come up with stable decisions from creative sources. Different leaders in health related organizations are then allowed to determine whether the implemented policies have obtained the desired results. Afterwards, the amendments go through legal process to become laws.

The second phase in policy modification is operation.[3] This is the stage where the changes in the policy are put into program to assess their efficiency. Both the internal and external stimuli have an impact on policy modifications. The internal stimulus controls the results, establishes the principles and views the changes in the operations. Whereas the external stimulus ensures that individuals have an opportunity to make modifications. This forms a cyclic relationship in the modification of policies. The modification process involves two structural phases: oversight and evaluation.[4] The legislature, courts and chief justice encompass the oversight authority. The purpose of policy modifications are; to analyze and evaluate the implementation and efficiency of laws, to determine whether additional laws are required and whether the amendment of one policy interferes with the desired results of another policy.

 The courts have played a major role in modifying the health policy. Overall states payment rates, antitrust rulings and exposure decisions are the areas of health policies that have been modified through law enforcement. Evaluation processes determine worth of appropriate processes in certain criteria. It involves three approaches; before and after comparisons, actual verses planned performance comparisons and with and without comparisons. The evaluation process takes place throughout the entire process. The only limitation with these approaches is that they do not determine causation. Alternative approaches that determine causation are experimental and quasi-experimental designs and cost-oriented policy evaluation.

The U.S. has come up with appropriate health policies that protect the rights of the Americans. On various occasions, the laws enacted may have minor or major problems. The policy modification process enables such laws to be implemented through legal procedures. Hence, the policies stand to benefit both the government and the American citizens. These health policies are results of prior policies that had been enforced. It is important to note that the positive or negative consequences of health policies result to policy modification.


Beaufort Longest. Health Policymaking in the United States. Chicago: Health Administration Press, 2010.

Davidson Stephen. A New Era in U.S. Health Care: Critical Next Steps Underthe Affordable Care Act. Stanford, CA: Stanford University Press, 2013.

Estes Carroll and Williams Eva. Health Policy: Crisis and Reform. Burlington, MA: Jones & Bartlett Learning, 2013.

Knickman Jonas and Kovner Anthony. Health Care Delivery in the United States. New York: Spring Publishing Co., 2011.

1. Stephen Davidson, A New Era in U.S. Health Care: Critical Next Steps Underthe Affordable Care Act (Stanford, CA: Stanford University Press, 2013), 34.

2. Jonas Knickman and Anthony Kovner, Health Care Delivery in the United States (New York: Spring Publishing Co., 2011), 179.

3. Longest Beaufort, Health Policymaking in the United States (Chicago: Health Administration Press, 2010), 123.

4. Carroll Estes and Eva Williams, Health Policy: Crisis and Reform (Burlington, MA: Jones & Bartlett Learning, 2013), 140.

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