In this policy resource, Dr. King describes and discusses the effects of the major federal regulations that govern health care financing, pharmaceuticals, professional and hospital care, and the
Highlights
Introduction (Chapter 1)
During the 20th Century, Congress enacted legislation authorizing regulations that now govern all aspects of health care. Federal Health Care Regulation provides an overview of these regulations.
Health Care Financing (Chapters 2-5)
Federal statutes and regulations have a major influence on health care financing. The U.S. tax code encourages individuals to obtain health insurance through their employer and to obtain comprehensive health insurance. The Health Maintenance Organization Act encourages employers to offer prepaid group health plans. The Employee Retirement Income Security Act (ERISA) encourages employers to self-insure. Because ERISA preempts state insurance requirements, it has a deregulatory effect on group health insurance. Federal health insurance mandates provide benefits to many Americans, but may result in higher prices for others.
Direct Regulation of Physicians, Hospitals, and Manufacturers (Chapters 6-9)
The federal government also directly regulates physicians, other healthcare professionals, and companies who manufacture pharmaceuticals and medical devices. The Food and Drug Administration regulates all aspects of developing new pharmaceuticals and medical devices. The Center for Medicare and Medicaid Services regulates hospitals and physicians with respect to access, quality, and billing. Recently, the Department of Health and Human Services implemented privacy regulations that govern all persons and organizations that come in contact with patient health information.
Alternatives to Present Federal Regulation (Chapter 10)
Federal regulations have benefits, but they also have costs. Federal Health Care Regulation discusses a number of possible alternatives to our present regulatory structure.