Running head: HEALTHCARE POLICY IN GEORGIA 1 HEALTHCARE POLICY IN GEORGIA 2 Healthcare Policy in Georgia - Final Submission South University Table of Contents Public Policy in the United States Federal System 2 Health Care Policy in Relation with the Constitutional Provisions 4 Government of the Healthcare Policy 6 Exploring the Health Care Policy in Georgia 6 Interest Groups in the Healthcare Policymaking Process 7 Political Influence of Healthcare Policymaking 8 Role of the Executive Branch of Georgia in Regards to Health Policies 10 Position of Healthcare Policy in the Governor’s Priority List 10 Administrative Agencies that Deal with the Healthcare Policy 11 Resource Allocation towards Healthcare Policy Implementation 11 Role of the Local Government in Formulating and Implementing Health Policies 12 Funding the Healthcare Policy 14 Public Policy in the United States Federal System Comprehensive knowledge on public policy is important for effective citizens and public administrators. Public policies govern all economic sectors that drive a country forward including education, trade, and healthcare. Hence, adequate information on public policy allows administrators and citizens to identify policy-gaps that can affect their livelihoods in terms of their physical and emotional well-being, finances, academics, and employment opportunities. According to Portz (2011), public policy in the United States relates to federalism, which is the allocation of powers and responsibilities to different arms of the federal government. They include the local, state, and national governments. Hence, the interactions between these arms and the distinct economic sectors in a country make the public policy processes complex. This paper discusses the U.S. healthcare policy where the national arm has the primary responsibility while the states perform secondary but also significant roles. In the U.S. federal system, policymaking has both merits and demerits. According to Crawford et al. (2012), healthcare policy makers and stakeholders have failed to involve patients during policy discussions. An effective healthcare policy ought to put patient needs first before looking at other stakeholders such as nurses and physicians. As a result, the National Health Centre continues to fight for effective changes in the policy area, such as faster development of new medicine, more comprehensive health research, and equal access to quality and affordable medical care for all citizens. Evidently, these changes represent the gaps in the current healthcare public policies. The main work of federal governments is to formulate public policies (Portz, 2011). In this case, a policy refers to a series of activities by public officials with the intention of achieving desired outcomes and dealing with matters of concern. Healthcare remains a priority area of American public life where government officials have engaged in several discussions and activitie ...

1. Running head: HEALTHCARE POLICY IN GEORGIA 1
HEALTHCARE POLICY IN GEORGIA 2
Healthcare Policy in Georgia - Final Submission
South University
Table of Contents
Public Policy in the United States Federal System 2
Health Care Policy in Relation with the Constitutional
Provisions 4
Government of the Healthcare Policy 6
Exploring the Health Care Policy in Georgia 6
Interest Groups in the Healthcare Policymaking Process 7
Political Influence of Healthcare Policymaking 8
Role of the Executive Branch of Georgia in Regards to Health
Policies 10
Position of Healthcare Policy in the Governor’s Priority List 10

2. Administrative Agencies that Deal with the Healthcare Policy 11
Resource Allocation towards Healthcare Policy Implementation
11
Role of the Local Government in Formulating and Implementing
Health Policies 12
Funding the Healthcare Policy 14
Public Policy in the United States Federal System
Comprehensive knowledge on public policy is important
for effective citizens and public administrators. Public policies
govern all economic sectors that drive a country forward
including education, trade, and healthcare. Hence, adequate
information on public policy allows administrators and citizens
to identify policy-gaps that can affect their livelihoods in terms
of their physical and emotional well-being, finances, academics,
and employment opportunities. According to Portz (2011),
public policy in the United States relates to federalism, which is
the allocation of powers and responsibilities to different arms of
the federal government. They include the local, state, and
national governments. Hence, the interactions between these
arms and the distinct economic sectors in a country make the
public policy processes complex. This paper discusses the U.S.
healthcare policy where the national arm has the primary
responsibility while the states perform secondary but also
significant roles. In the U.S. federal system, policymaking has
both merits and demerits.
According to Crawford et al. (2012), healthcare policy
makers and stakeholders have failed to involve patients during
policy discussions. An effective healthcare policy ought to put
patient needs first before looking at other stakeholders such as

3. nurses and physicians. As a result, the National Health Centre
continues to fight for effective changes in the policy area, such
as faster development of new medicine, more comprehensive
health research, and equal access to quality and affordable
medical care for all citizens. Evidently, these changes represent
the gaps in the current healthcare public policies.
The main work of federal governments is to formulate
public policies (Portz, 2011). In this case, a policy refers to a
series of activities by public officials with the intention of
achieving desired outcomes and dealing with matters of
concern. Healthcare remains a priority area of American public
life where government officials have engaged in several
discussions and activities to create laws and to design programs
that address perceived needs. Hence, it is normal for
policymaking to be contentious and complex since government
bureaucrats and policymakers from the local, state, and national
levels often have distinct perspectives and interests regarding
the formulation and implementation of particular policies. For
instance, in the U.S healthcare sector, state governments
rejected the latest national health reform act by claiming that it
conditioned citizens to contribute more to medical care costs.
Apparently, the Constitution fails to give specific
responsibilities or power to state governments. However, the
10th Amendment reserves the powers that have not been
delegated to the national government to the states and the local
people. Nevertheless, since healthcare and education are not
mentioned in the Constitution, it is unclear which arm of
government should be responsible for the two policy areas fully.
Similarly, local governments, such as school districts and
municipalities, are not mentioned anywhere in the American
Constitution.
As a result, there is an ineffective distribution of
constitutional power in the U.S healthcare sector. As a policy
area, the sector is shared among all three intergovernmental
arms, although the state and national levels share the major
responsibilities: the quality of medical care, healthcare costs,

4. and healthcare access to all Americans. Correspondingly, this
creates a high level of interdependence among the governmental
arms concerning the formulation and implementation of
healthcare policies. Thus, even though national policymakers
have the biggest role, under the federal authority, of creating a
specific policy, they have to rely on state and local governments
for the final service delivery. However, this interdependence
can fail to be beneficial when competition and conflicts play a
part. Therefore, the American Constitution should clarify
directives about public healthcare policies and people’s rights
in the sector to provide distinctive roles to the three arms of
government. Health Care Policy in Relation with the
Constitutional Provisions
The state of Georgia has not performed well in the health care
sector within the past decade as depicted by health rankings
over the period. The biggest contributors to this state are poor
dental facilities and poor implementation of health insurance
policies. Georgia also depicts the highest mortality rate for HIV
victims not to mention the above average number of deaths for
victims of heart disease and diabetes. Nonetheless, following to
the implementation of Obamacare, better services have been
provided as the state government adheres to the constitutional
provisions more keenly. Adherence to the healthcare policy in
accordance with the state constitution has facilitated an
improvement of healthcare service provision especially from
2012.
To begin, Article 37 of the constitution of Georgia states that,
‘Everyone shall have the right to enjoy health insurance as a
means of accessible medical aid. In the cases determined in
accordance with a procedure prescribed by law, free medical aid
shall be provided (Hill & Georgia, 1994).’ However, the state
has not paid appropriate attention to this provision owing to the
statistical evidence that approximately 39% of citizens in
Georgia lacked health insurance covers as at 2009 (Plunkett &
Plunkett, 2011). As such, the substantiation shows that even
with this provision, more Americans continued to suffer from

5. health-related disparities owing to the poor implementation of
the health policy as mentioned in the constitution.
Another provision as mentioned in the constitution in regards to
the healthcare policy states that, “The state shall control all
institutions of health protection and the production and trade of
medicines” (Article 37, 2). This provision has been particularly
helpful to the citizens because the state has managed to ensure
that only medicine that reaches the standards is sold to the
state’s public. According to health records, about 16 percent of
Americans die each year due to the ingestion of medicine that is
poorly manufactured or that has reached the expiry dates due to
extreme shelving (Brooks & Huggett, 2012). In the sixteen
percent, only 1.8% accounts for the deaths in Georgia as
compared to other states with 4 percent. The legislative body
remains responsible for upholding this provision of the
constitution through quality assurance departments.Government
of the Healthcare Policy
The health care policy is appropriately governed through the
legislative arm because of the development and implementation
of policies now and in the future. Policy development remains
necessary in the state of Georgia because the legislative arm can
develop policies purposed at solving particular concerns for the
public. For instance, the state could develop a policy that
requires all diabetic patients to have a medical cover with the
intent of reducing their hospital expenses and lowering the
mortality rates pertaining to that particular disease. The
healthcare policy shows importance to the general public as it
seeks to ensure that healthcare facilities are readily available
for all citizens to ensure delivery of quality services. The
Georgia Health Policy Centre (GHPL) works in conjunction
with the state government to facilitate the implementation of
these policies within the state. Over the recent past, the
organization has sought to involve the public more in matters
pertaining to healthcare purposed at increasing publicity on the
need for insurance covers. Through such initiatives, the citizens
have become more engaged in caring for their health hence the

6. noteworthy decline in mortality rates. In this regard, sustaining
such publicity will enhance public awareness and contribute to
quality delivery of healthcare services within the state of
Georgia.Exploring the Health Care Policy in Georgia
Policies, plans, and strategies within the healthcare system are
not culminations by themselves. Altogether, they form part of
the larger approach that purposes to align a country’s set
priorities with the actual health needs of the public. Through
health and developmental partners, inclusion of the private
sector, consideration of the civil societies, and the participation
of the government not to mention the political parties, health
policies effectively influence the available resources in favour
of the public. Healthcare surfaces amongst the essential aspects
in today’s life amongst education and transportation further
indicating its necessity to the global population. These
strategies and healthcare policies thus ensure that all citizens
under state and federal governments have unlimited access to
valuable healthcare services thus living longer and healthier
lives (Chard, 2004). In relation to finances, better healthcare
lowers government expenditure thus allowing the allocation of
the saved resources to other departments such as education or
agriculture. In that, a surplus of quality healthcare services is
inversely proportional to demand of the same.
From another angle, the significance of healthcare policy and
procedures remains undisputed as depicted by the active
participation of healthcare personnel. Policies in healthcare
demonstrate importance as they establish a general plan of
action, which is utilized by the various healthcare facilities as a
guide towards the achievement of mutual goals. In a state such
as Georgia, it communicates to healthcare personnel the desired
results of their participation thus aligning their diverse roles
towards a mutual objective such as the provision of quality
services (Abood, 2007). As such, all hospitals within a
particular locality, such as Georgia in this case, end up
providing standardized services thus ensuring that everyone
receives quality services regardless of the hospital they visit.

7. Therefore, healthcare policies set a platform for the delivery of
safe, quality, and cost effective services hence illustrating their
prominence to the population.Interest Groups in the Healthcare
Policymaking Process
Interest groups within the healthcare sector are those
stakeholders who have the potential to influence the outcome of
a proposed policy. These actors can either limit the progression
of a proposed policy to maturity, or, on the contrary, propel a
policy to maturity and oversee its implementation in the
healthcare sector. Therefore, the final voting decision relies on
more factors and not only the presented merits and demerits of
the policy (Abood, 2007). The most renowned stakeholder
includes political parties, district voters, legislators,
committees, and selected representatives from select healthcare
agencies, which either represent the needs of the public or those
of the healthcare personnel. In a quest to shape the final content
and result of the proposed policy, whether it is a new policy or
an amendment of an existing policy, there arises a need to
identify the supporters as well as the non-supporters of that
particular policy. As such, the parties seeking to push a certain
policy through need to be in constant communication with the
members of the germane committees, the chairperson, and most
importantly the supporting legislators. Representatives of the
public also play a significant role in policy formation because
they present the public’s opinion and in most cases, their
opinion is taken more seriously owing to the large number of
people being represented.
The non-supporters in most cases comprise of the interest
groups who find the proposed policy either impractical to
implement, expensive to implement, or subjective to a particular
party more than another. For instance, if a policy to reduce
employee working hours would be favouring the doctors and
nurses amongst other personnel, but disregarding the needs of
the public who require health services around the clock. As
such, no representatives of the public would be in support of the
policy thus limiting its progression. Legislators ask themselves

8. a series of questions before they choose to support or oppose a
particular policy. Some of these considerations would include;
how does this policy affect my district? What is the public
opinion about this policy? Is the represented political party in
support of this policy? As such, the needs of the public need to
be in harmony with those of the political party and other
interest groups to ensure that a policy under review benefits all
interested parties equally and facilitates value addition in the
healthcare sector (Abood, 2007).Political Influence of
Healthcare Policymaking
The preferences of the elected party officials play a vital part in
steering any healthcare policy moving through the policy
process towards development, implementation, and consistent
evaluation for performance. Based on the number of political
parties represented, there could be any number of diverse
opinions, which at times portray competition amongst
themselves not to mention the interests of the democrats and
republicans. In such instances, the political party that holds the
majority seats is more inclined towards winning the support of
other interest groups subject to the policy under review. In the
state of Georgia, for instance, party preferences are to ensure
that all policies established under the state constitution add
value to Article 37 of the constitution (Hill & Georgia, 1994).
Therefore, policies under the state constitution are bound to
facilitate accessibility of medical aid through means such as
increasing the number of facilities, boosting the standards of
service provision, and supporting the insurance system to cover
more people and consequently sinking the prices for such
services. Decision makers thus rely hugely on the political
influences as they attempt to find an acceptable and feasible
directive amidst the conflicting proposals, values, and demands.
Deeper political involvement is prompted in policy changes that
involve noteworthy costs to the state government, or those that
trigger substantial controversies between the public and the
healthcare personnel.
All stakeholders in the state of Georgia need to strategize prior

9. to entering the legislative arena to ensure that they utilize their
political influence and power of mass numbers effectively
towards the development of effectual policies (Barker, 2006). It
is vital to understand the steps within the legislative process
and knowing the powerful players to effectively strategize and
carry out these strategies. Operative communication with
legislators and the committee members also plays a vital role in
the legislative activity as it fosters polished communication
skills between the interested parties. Georgian legislature
depicts active involvement in issues concerning policies as it
ensures that all interested parties are represented. In addition, it
provides a systematic process that all policy proposals must
follow before they have matured to the implementation stage.
The state of Georgia has also been ranked sixth in all American
states in its health policy development and implementation in
the last three years further showing the efficacy of their
legislative arm (Institute of Medicine (U.S.) & National
Academies Press (U.S.), 2011).Role of the Executive Branch of
Georgia in Regards to Health Policies
The executive branch of the state of Georgia plays a vital role
in the administration of the health policies in pursuit of
protecting the health of all citizens. It does this by ensuring that
research is continuously conducted to avail new medication for
existing illnesses and at the same time prevent outbreaks.
Furthermore, it implements policies of food and drug safety
while ensuring that the residents receive health insurance in an
attempt to improve accessibility to healthcare. The office of the
governor listed healthcare amongst the six most prioritized
items for this term alongside provision of jobs, improvement of
education, reformation of the justice system, natural resources
and development of transportation and infrastructure (State of
Georgia, 2015). Position of Healthcare Policy in the Governor’s
Priority List
In regards to healthcare, the governor made it his priority to
meet the demands of the growing population by devising and
implementing sustainable and long-term solutions starting with

10. fostering a culture of wellness (Nash, 2015). The state would
promote Georgia’s public image by advocating for healthy
lifestyle choices from a personal level. In addition, the governor
would strengthen Georgia’s healthcare workforce by identifying
innovative ways to attract and retain highly qualified personnel
in healthcare. As such, the state would work hand-in-hand with
medical colleges as well as the Department of Community and
Public Health (DCPH) to promote Georgia’s ideal practice of
world-class medicine. The DCPH was also tasked with
advancing biotechnology research and innovation in the state of
Georgia. Moreover, the state government allocated $2.59 billion
to improving healthcare, which indicates a 6.5 percent increase
when compared to the previous budget allocation (Raminashvili,
Bakhturidze, Zarnadze, Peikrishvili, & Bull, 2014). The state
has been a victim of rising mortality rates owing to conditions
such as hypertension, obesity, and diabetes; hence, the
additional resources are to be used to facilitate improved
service provision while facilitating campaigns for healthy living
among the citizens. With such resources, the governor hopes to
improve research and development hence offering better
services and drugs to the people of Georgia. Besides improving
healthcare, these spurs will avail more jobs for the public,
encourage education, and lower crime thus serving more than
one purpose. Administrative Agencies that Deal with the
Healthcare Policy
Healthcare Faculty Regulation (HFR) and Healthcare Georgia
Foundation (HGF) are some of the agencies that deal with the
healthcare policy implementation in Georgia. The HFR is a
branch of the Department of Community Health (DCH) that is
responsible for the planning of healthcare, certification,
licensing, and the oversight of healthcare facilities within the
state (Vanessa, 2014). Similarly, the HGF, which is a private
and independent organization, seeks to advance healthcare
services for all Georgians through expansion of access to
affordable and quality healthcare with a particular interest in
the underserved populations. Amongst other agencies, these two

11. ensure that health facilities offer unwavering quality services as
well as expanding accessibility. Resource Allocation towards
Healthcare Policy Implementation
The allocation of additional resources by the state government
demonstrates the governor’s efforts to improve and sustain
quality and accessibility in the healthcare sector in Georgia.
Evidently, sufficient resources are aligned towards this goal.
The HFR, under the counsel of the DCH further ensures that all
Georgian health facilities adhere to the set policies strictly to
ensure that the quality of health services is balanced in all
facilities. As such, all Georgians receive equally worthy
healthcare services thus eliminating preference and accusations
of favouritism towards the state government. Role of the Local
Government in Formulating and Implementing Health Policies
Policy-making remains highly undervalued and
miscomprehended in the public eye, yet it forms the central role
of the federal, state, and local governments. The policies
formulated by these bodies have an effect on every individual
whether directly or indirectly. More precisely, health policies
determine the health services to be provided to the Georgian
population, the quality of these services, and the development
strategies to be implemented to facilitate advancement in this
field. Policies also guide the decision-making process as they
put the public’s needs first. In other words, policy development
and implementation remain a complex process in which the
local government plays a vital role.
Georgia’s local government plays a part in healthcare policy
initiation, formulation, adoption, and implementation by
providing the best of local official to serve as representatives of
the public (Falleth & Hovik, 2009). An operative healthcare
system ought to be guided by firm policies aligned towards
assuring the delivery of quality services. The local officials also
outline the political and financial prerequisites for policy
formulation to ensure that all the necessities are readily
available before the process takes off. Furthermore, the local
government utilizes five core-guiding pillars, which ensure that

12. their role in healthcare policy formation and implementation
remains focused on the well-being of Georgia’s residents. First,
they make sure that the process remains transparent with all
decisions made with the public interest as the priority. The local
government also oversees sustainable development and
micromanagement of allocated resources in line with delivering
effective services (Costigliola, 2012). Its democratic
representation and social inclusion guarantee that the
community is engaged in issues pertaining to their welfare and
allowed to give their opinion. Good governance through the
ethical, legal, and moral conduct of its personnel and councilors
also surfaces amongst the pillars on which their governance in
regards to healthcare policy formulation is built.
Georgia’s local government, through its personnel, follows the
following steps in the process of healthcare policymaking. To
start with, it assesses the public health interest of the particular
policy by narrowing down its purposes to see if it accomplishes
a compelling health objective. Evidently, this step eliminates
possible bias through a critical evaluation of the policy
rationale. Secondly, the local government examines the
inclusive efficacy of the policy by comparing the possible
outcomes to the stated goals. In this phase, the officials gather
scientific data and blend it with logic to weigh its feasibility.
Next, it evaluates whether the policy is well targeted by
identifying whether it is under-inclusive or over-inclusive. The
bigger the target population the more difficult it is to implement
because it requires more resources, which could be a challenge
at times. Under inclusive policies, on the other hand, do not
carry as much weight as they should because only a small
number of people benefit from its implementation. Additionally,
the passing ofunder-inclusive policies calls for numerous
policies in pursuit of catering for the public’s entirety.
The local government then proceeds to identify the human
rights burdens, which requires an in-depth inquiry into the
nature, scope, invasiveness, and duration of human rights
desecrations (Lubitz & Wickramasinghe, 2006). In other words,

13. it assesses whether the policy interferes with the various
individual rights or if it exerts weight the economic and social
rights of the people. Finally, it scrutinizes whether the proposed
policy is factually the least restrictive alternative for that
particular problem. The officials verify whether the health
objective could be achieved with fewer or no restrictions on the
existing human rights when compared with those highlighted for
its implementation. Successfully, this phase of the policymaking
processes warrants that societal and individual rights are
accommodated in that policy. Funding the Healthcare Policy
Starting from the 1990s, Georgia’s healthcare was under a tax-
funded system until late 1995 when reforms introduced a social
insurance model controlled by the State Medical Insurance
Company (Foundation Centre, 2000). Under this model, the
state insurance company paid for basic healthcare; as
supplementary funds from Municipal Health Funds facilitated
slow but gradual advancements. As a sustenance strategy, a
State Health Fund was placed mandatorily on all employers and
employees through the payroll system to finance the health
insurance model. The municipal budget also contributed to
funding the new model as it paid a flat rate amount for each
person within the municipality. Being operational for more than
a decade, public sources and grants started supporting Georgia’s
healthcare policies with an interest in the rural population and
children aged six years and below (Saltman, Bankauskaite &
Vrangbæk, 2007).
The ministry of Health, Labour, and Social Affairs also plays a
part in funding policy formation and implementation in Georgia
for citizens living below the poverty line thus assisting them to
purchase health insurance and receive healthcare services.
These means of funding should not be changed because they
account for the whole population whereby those above the
poverty line contribute to ensuring that those below the poverty
line receive quality healthcare services as well. In light of
policy development and implementation, the implemented
strategies ensure that even the minority groups in the state are

14. attended to as depicted by the utilization of grants to facilitate
policy formation for people living in the rural areas.
References
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Barker, C. E. (2006). The health care policy process. London:
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Brooks, B., & Huggett, D. (2012). Human pharmaceuticals in
the environment: Current and
Future perspectives. New York: Springer.
Costigliola, V. (2012). Healthcare overview: New perspectives.
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Chard, R. E. (2004). The mediating effect of public opinion on
public policy: Exploring the
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15. as a strategy. Local Environment, 14(3), 221-231.
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16. Running head: HEALTHCARE POLICY IN GEORGIA
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Healthcare Policy in Georgia
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Final Submission
South University
Running head: HEALTHCARE POLICY IN GEORGIA 1

17. Healthcare Policy in Georgia - Final Submission
South University