Of policy is analytical and descriptive – explains policies, their developmentFor policy is prescriptive – formulates policies and proposals
Not a linear process; values are enmeshed; personal experiences, opinions and motives abound; politics rulePolicies can be enacted in spite of hard data that says they are crazy and impractical
AS – identifying societal problems and bringing them to attention of government – who does that?LR – formal governmental responses to a problem – who does that?I – execution of policies or programs to solve problemsE – appraisal of policy performance or outcomes
Politics is a market of quid pro quoLegislators, executives and bureaucrats, judgesAnyone who considers potential or actual policies to be relevant to the pursuit of health for themselves or others (multiple motivations)What is the dynamic that drives the interaction? POWER – the potential to influence
Who has all this power? Suppliers? Demanders? In what ways?
Who is involved in the power play? Is power a good thing or a bad thing? (It’s just a fact of life)
What are some flaws in this process? lowest cost may not be best solution emotional issues POLITICSWhat about these evaluation criteria? What could they be? (cost, access for greatest # people, political acceptability to voters or wealthy supporters, maximum revenue generation, maybe even public good as defined by a specific group)
These authors separate policy planning research (in-depth, longer term project conducted by academic researchers with basic policy analysis that seeks answers to more immediate problemsIn their view, basic analysis results in issue papers, recommendations to legislators, policy papers, all prepared for a specific client or political purpose – while policy planning results in extensive and in-depth exploration of a problem from the perspective of public good.Rational separation??
Bob Dole example “we really win if we win, but we win if we lose too” regarding Senate rejection of BBA in 1994 (p.2)Policy and politics are inseparable – we can’t get above the fray and mess of politicsRational decision-making approach doesn’t often work in the real worldl society does not function exactly like a market; rational model of policy-making is not orderly and defined any nore than rational decision-makingSometimes the solution comes before the analysis – facts are culled and shaped to match what we want to do
What comes first, the goal or the solution? Answer – it depends on who is shaping things equity, efficiency, security, libertyHow are problems defined? Answer – it depends on who is shaping the problems, whose interest is being served problems are not the same for a Wall Street Banker and a laid off steel worker from Ohio symbols, numbers, causes, interests, decisions (remember the purpose of policy is to accomplish someone’s agenda)Solutions use some form of power to change or coordinate behavior inducements (persuade), rules (command), facts (from rational persuasion or propaganda), rights, powersSolutions are temporary, fleeting resolutions of conflict through deliberate attempts to change people’s behavior through policy.
Obama support for women’s healthHRSA confirmation of benefits for women from legislationRomney accuses obama campaign of using woman’s death for political gain CNN John King analysis of Romney position on women’s issues
Determining which of variousalternative policies will mostachieve a given set of goalsin light of the relationshipbetween the policyand the Analysis of policygoals Analysis for policy
Ethical Values BeliefsPublic Acquisition Money of moreGood power
ANALYZE HEALTH POLICY! So in the context of policy process, we…
Policy “should” achieve maximum benefits at minimal cost Verify, define and detail the problem Establish evaluation criteria Identify alternative policy options Monitor implementedEvaluate alternative Display and distinguish policy after policies among alternatives enactment
Define the problem Assemble evidence Construct alternatives Select evaluation criteria Project outcomes Confront trade-offs Decide on “best” policy to promote Tell story to your policy audience
Define problem Set evaluation criteria Identify alternative policies Evaluate alternative policies Select preferred policy Re-define problem
Always a paradox Rationality in the political process is an irrational dream Analysis itself is political – carefully crafted to support positionsPolicy is about ideas that often clash in the political arena
Rational attempt to attain objectivesstrategic representations of situations put forth by the proponents of a political positionStructuring relationships and coordinating behavior to achieve goals (hopefully for the common good)