Global Policy Leadership Final Report - 21F

The students of Public Policy 85: Global Policy Leadership completed ten weeks of study at Dartmouth and two weeks of field study in Washington, D.C.​​​​​​ in Fall of 2021. Below is the introduction to their policy brief. You can download their full report here.

The United States healthcare system is composed of a variety of public agencies, public and private research institutions, private companies, and diverse stakeholders. Health insurance coverage is offered through a mix of public and private bodies: Medicaid, Medicare, and private insurance companies. In addition to traditional public health issues such as infectious disease control and the regulation and distribution of medical products, public health involves many aspects of domestic social policy. Climate change, housing insecurity, childhood poverty, racism, and economic inequality, among other issues, affect individuals' health and society's collective health levels. An approach to reforming the healthcare system therefore requires a broad perspective and an appreciation that the healthcare system is part of a policy ecosystem rather than a single domain.

The approach taken in this memorandum, "Health Care Infrastructure, Legislation, and Innovation in the United States," situates health care as a part of the broad U.S. social policy ecosystem and offers reforms that stretch within, across, and outside of the healthcare system. The memorandum begins with an overview of public health, defining public health, establishing the role of government in public health, and briefly outlining key concerns with public health at present: infrastructure, delayed prevention and response strategies, and a lack of access.

When taken together, the reforms presented in this memorandum offer multiple paths toward improving and reforming the United States healthcare system in both incremental and transformative ways. While many of the reforms can, and should, work in conjunction with one another, the strength of this memorandum is that each reform can also stand alone, thereby providing policymakers with a variety of tactics to approach present issues facing the healthcare system.