Health policy is a subset of _____ policy

Public Policy

gov't action > r/t what has been identified as public issue

Theory

• A framework for understanding how a set of facts or phenomena comes to be.
• set of statements or principles developed to explain these facts or phenomena

Public policy theories

• each explains the nature of decision making in the public policy process
• each emphasize a different features of the public policy process > to explain how governments make decisions and develop public policy
• Each has a different approach to understanding the influence of power and how it is exercised in the public policy process
• Each has a set of values that inform their approaches.  Each is also informed by a general model of society and how society is considered to function

• Theories of public policy process may take the view (X3) of:

1. macro-view
2. meso-view
3. micro-view

Theories can be distinguished as being either _____ or _____ models of public policy

_____ can be distinguished as being either consensus or conflict models of public policy

[A] Macro-view theories

• Consider broad issues of the general shape of political system and how power is exercised in these political systems. 
• Analysis of such profound differences (private vs public funded health care) is the focus of macro-level theories.

Health policy

• Health policy consists of two types of public policy

1. organization and delivery of health care services
2. development and implementation of health care policy

the first type of health policy

• concerned with the organization and delivery of health care services. 
• Eg. whether health care services are publicy or privately financed (as a right or a commodity to be bought/sold)

the second type of health policy

• concerned with the development and implementation of health-related public policies
• if value equity & human rights > policies assure economic and social security
• if don't value human right > market-oriented approaches to provision of goods and services

Public funding

• govt provides funding and delivery of HC services
• health risk shared across popn

The value that underlies publicly financed health care is that _____ risk is shared across the population.  

The value that underlies _____ financed health care is that health risk is shared across the population.  

Private funding

• govt NOT involved in financing/delivery
• free enterprise and the commodification (selling) of goods and services

The value that underlies the privately financed health is that of free enterprise and the commodification (or selling) of ____ and ____, including health care. 

The value that underlies the _____ financed health is that of free enterprise and the commodification (or selling) of goods and services, including health care. 

[A₂] Health related

• society values equal rights produce policies that assure economic & social security
• if NOT > favor market approaches to provision of goods and services
• Eg. day care

[B] Meso-view theories

• focus > influence of advisory boards and departments within govt, govt ministries, and "middle-level" organizations upon public policy

Middle level institutions

(meso-view)

• organizations within governments charges with particular responsibilites
• indep agencies that, while established by govt, operate at arms length.
• BOTH are accountable to govt for their decisions and public recommendations
• make recommendations of both types of policy: health care-related & health-related public policy

[C] Micro-view theories

• concern w/ admin routine and day-to-day government apparatus that shapes policy making
• monitoring operation of govt operations, incl *spending allocations * monitoring operations * revising guidelines for practice

HEALTH POLICY ISSUES AT DIFFERING LEVELS OF ANALYSIS

(Macro-level > Health care policy)

3 theories of Public Policy

1. pluralism
2. new-institutionalism
3. political economy

Pluralism

(1 of 3 theories of PP)

aka: pluralist interest group theory

• society =  interest groups that vie for power and access to the state to realize their goals and objectives
• * assumes all groups have same opportunity to influence the policy change process
• democratic societyes are ogranized in the interest of the citizenry & all groups have equal opp influence govt directions (policy change pcs)
• Policy emerges from competition in developing and advancing ideas among these different groups (cost vs benefits)
• identifies the different interst groups and how they are organized
• it documents the nature and success of their attempts to influence the public policy change process

The Pluralist View 1/4: basic political rights to vote and free speech safeguard political equiality and individualism. Citizens access to govt via competitive elections. influence govt through _____ for policy changes in other activities

• political rights
• citizens' access to political power
• responsiveness of political system to provide rational PP outcomes

• business community
• market forces
• civil society orgzn (social movement, unions, organizations)

Easton's Model of the Political System

INPUTS: Demands, Support, Resources

the GOVERNMENT

OUTPUTS: Goods and Services

New Institutionalism: (2 of 3 theories of PP)

many political science models of public policy change adopt a _____-driven political process

new institutionalism > focus on analysis of how soc institutions influence public policy making

• determine the _____ and _____ of political action

• historical institutionalism
• rational choice institutionalism
• sociological institutionalism

historical institutionalism

traces how the past shapes the future

rational choice institutionalism

sociological institutionalism

which emphasized culture and norms and determining influences

political institutions

Defining Political Institutions:

new institutionalism

Defining Political Institutions:

Institutionalist

Historical institutionalism

Historical Insitutionalism

the Political Economy Approach offers the most useful means of understanding how ____ ____ is created and implemented

Political economists look at states, markets, power, ideas, discourses, and civil society and their impact on policy _____

the new-institutionalist emphasis on the primacy of ideas > Materialist-Political Economists consider that how a society organizes production and distribution of social and economic resources shapes _____ and _____

[1] The mode of production

Box 3.2 p65

feminist political economy considers how the political, economic, and social organization of health structures opportunities for _____ for women

Political Economy as Critical Social Science Applied to Public Policy

• materialist (a political economy perspective) is also a critical social science perspective
• Political economy concerned with issues of power, and as critical social theory it embodies a transformative component

• People have the power and ability to change their _____ (i.e., living condn, communities health)

• People have the _____ and ability to change their enviro (i.e., living condn, communities health)

• ++ important outcome of a political economy analysis is how power impacts policy change, which then impacts the _____ of population

• ++ important outcome of a political economy analysis is how power impacts _____ change, which then impacts the health of popn

Accumulation

Legitimation

• ensures social cohesion and mediating conflict among social classes by providing a justice system and servies
• The state's socially sanctioned right to use force in order to ensure social order and cohesion (b/w employers and empolyees) > to reduce risk of possible class conflict