Medical Management Committees and Health Policy

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Please refer to attached file response for better formatting, which is also presented below. As well, I have attached two highly relevant examples. I hope this helps and take care.

RESPONSE:

Let's look at your questions in the order that you presented them.

1. Identify at least two medical management committees within an health care organization...

For example, the HCO (The foundation, PO Box 1395 Eureka. CA 95502) on the website URL: http://www.hdnfmc.com/Protocols.PDF p. 5 lists the following medical management committees:

a. Medical Management Committee
b. Mental Health Administrative Committee
c. Mid-level Administrative Committee
d. Other Medical Management Committees on an as hoc basis

Another site lists the following medical management committees:

A. Facilities and Critical Care Committee

This committee evaluates/makes recommendations to the Emergency Medical Care Committee (EMCC) with respect to issues that impact hospitals and their interface with the EMS system.

B. Emergency Medical Care Committee

Each county may, under the Health & Safety Code, establish an Emergency Medical Care Committee (EMCC) with membership prescribed and appointed by the county board of supervisors. The EMCC acts as an advisory body to its board of supervisors and local EMS agency on all matters relating to EMS (http://www.cchealth.org/groups/ems/committees.php).

Please see attached article at the end of this response, which lists other committees and each of their respective duties of UCLA.

2. How can medical management committees influence the process of health policy making outside of their health care organizations?

At the policy level, several countries such as Sweden and Great Britain have begun to explore the implications of social policy beyond the health care system of the social determinants of health. For example, in Great Britain the Independent Inquiry into Inequalities in Health (known as the Achesan Report) examined the implication for health and health inequalities of a wide range of social policy including income and taxes, education, employment, housing and environment, transportation, nutrition and policies aimed at specific age groups. However, little systematic attention had been given to these implications for public policy in the U.S. (see http://www.bioethics.nih.gov/research/ehpolicy/socialdeterminants.pdf).

Further, AMA (as well as other HCOs) promotes and advocates its policies beyond the health organizations in various ways, such as:

· Communications;
· AMA representation on standard-setting and accreditation bodies;
· The legislative process at the national and state levels;
· Litigation;
· Advocacy campaigns at the national and state levels and advocacy in the private sector; and
· Advocacy to regulatory bodies. (Refer to attached file for more detail on AMA policy).

Other ways medical management committees influence the process of health policy making outside of their health care organizations are as follows:

- By joining other community (hospital, health departments, department of social services, etc.) and thus influence policy at these levels.
- By creating an infrastructure for state wide initiatives
- By collaborating with interested parties
- The Public Affairs Department provides representation before the United States Congress and the executive and regulatory branches of the government. The State Legislative Office maintains a clearinghouse of information on legislative and regulatory issues affecting emergency medicine. The office has information on more than 150 topics. Staff members are available to answer questions about active legislation in the U.S. Congress and pending regulatory proposals before federal and state agencies.
- The American College of Physicians develops policies on public health issues and advocates those policies on Capitol Hill. To advocate ACP policy, the College's Washington, DC office presents the views of the American College of Physicians to lawmakers and policy makers in Congress, federal agencies, and state capitals. Through events such as Leadership Day on Capitol Hill, internists from all over the country are invited to experience the process of federal health legislation and to promote ACP positions to congressional leaders ( http://www.acponline.org/hpp/hppmenu.htm).

See http://www.hcawv.org/shp/policy_assignments.pdf page 3 and 4 for other suggestions of ways committees can influence policy outside their own HCO (promotion, etc.).

3. List some legal and ethical dilemmas to consider when creating new policies.

Research is conducted on the ethical aspects of medical practice and health policy. Underlying research is the assumption that consideration of ethical issues is a fundamental ingredient of health policy. Medicine has become a highly complex pursuit involving many layers of organization that are expected to meet the needs of large populations of individuals who vary in their health status, needs and expectations. To provide health care and assure the health status of the public fairly and efficiently in our nation and other democratic societies requires the development of health policies that are based on both sound scientific evidence and fair procedures for priority setting. Research facilitates the capacity of others to make sound ethically informed policy and to collaborate with other parts of the Department of Health and Human Services that address policy questions (i.e., ethical dilemmas can arise around each of these questions):

What goals should be given priority in designing health policy? How can ethical deliberation and policy making be more effectively connected? What priority should be given to the worst off in society? How can the public become more involved in setting health care priorities? How can clinicians practice in ways that are respectful of patients given the many imposing realities they face in practice such as financial limits and the uncertainty inherent in the knowledge base they use in practice? How are scarce medical resources distributed and what is the effect on ethnic and economic disparities? How can policy makers assure public health when health care alone is a necessary but insufficient ingredient? Through its conceptual and empirical research, the Section on Ethics and Health Policy contributes to answering these questions. The ability to address them is an important ingredient in assuring the health of the public. In this sense, the work of the section contributes to the core mission of the NIH (http://www.bioethics.nih.gov/research/section-ehpolicy.html).

a. Ethical and legal issues concerning whether the procedures of policy making fair (i.e., do the health policies actually reflect the health determinants of society fairly and adequately or do other factors (i.e., global trade agreements) influence and contaminate health policies
(See ...