Policymaking in the United States

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Policymaking in the United States

Policymaking in the United States

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Q2: As stated on p. 295 of Health Policymaking in the United States, “The most difficult policy question deriving from application of the ethical principle of justice is, of course, what is fair?” how would you answer that question? What is fair?

Q3: As a health policymaker, what might your social power include?

If you do not know health care do not respond.

Power, one of its fundamental components, is at the heart of every policy process [1]. Policy-making is dynamic process involving the interplay of numerous forces, with power, one of its key components, at the heart of every policy process. 
The roles of the actors are critical to any policy process. 
Through their knowledge, experiences, beliefs, and power, the players have an impact on the process [1]. 
Despite the fact that power plays significant role in policymaking, empirical data reveals that health policy analysis in poor and middle income countries has paid little attention to the question of power [2]. 
Furthermore, power is rarely investigated because it is difficult to do so, as it necessitates combination of empirical facts and theorizing. 
The definition of power is also problematic, particularly when it is applied to research [3]. 
According to Dhal [3,] the way power is conceived and understood has consequences in policymaking. 
There are opposing viewpoints on power dynamics, including the widely held belief that power is and should always be distributed top-down.

 

Many arguments over policy processes characterize them as top-down, with no need for ground-level implementers to be involved. 
Many policies are inadequately executed in relation to their objectives as result of this traditional policy-making method [1, 4, 5]. 
Furthermore, if the implementers are not involved in the policy’s development, the chances of it being contested are substantially higher [5]. 
Policy implementers are typically at the bottom of the policy-making food chain, with little engagement in policy discussions [5–7]. 
As result, policy experts have suggested that alternate ways to policymaking and implementation, such as top-bottom-bottom-top techniques and bottom-up strategy, be used. 
As evidenced by the adoption of the World Health Organization’s (WHO) Framework Convention on Tobacco Control, which set precedent for global actions targeting the supply and demand feedback on tobacco use [8], such approaches have proven to be important in improving policy-making and implementation. 
This bottom-up policy-making strategy is also widely utilized outside of the health sector, with positive results [4].

 

In recent years, there has been shift toward more interactive and participatory policymaking [9, 10]. 
Interactive policy-making and planning, network management, stakeholder dialogue, deliberative democracy, policy discourses, and governance are some of the novel concepts underlying this method [4]. 
Policy dialogues are highly recommended as means of creating interactive and inclusive policymaking, but studies have found that they are only beneficial if they are well-run, participatory, and evidence-based [11–14]. 
Supporters of paradigm change in policymaking urge for greater stakeholder collaboration. 
Even in such collaborative processes, however, power cannot be overlooked. 
Power is manifested in real life in variety of ways, including resources, capacity, and knowledge [3, 4, 15]. 
Power, according to health policy researchers, nevertheless plays role in policymaking and should not be overlooked [1, 4, 15]. 
According to the literature, power influences policy processes and outcomes in variety of ways, including through actor relationships, trust, and policy-makers’ tactical exclusions of certain subjects or people [1, 4, 15]. 
Their arguments are based on variety of power theories that show how it affects actors’ organizational behavior and policy perspectives. 
Nonetheless, there is still lack of research into how power is distributed across players in various circumstances in regard to policymaking.

 

The European Union, the World Health Organization, and the Government of Luxembourg collaborated in 2011 to assist policy discourse on national health policies, strategies, and plans. 
The ultimate goal of this collaboration, known as the EU-Lux-WHO Policy Dialogue Program, was to enhance health sector outcomes in targeted countries, with general focus on supporting universal health coverage (UHC), people-centered health care, and health inclusion in all policies. 
The policy discussion program, in particular, aims to strengthen the capacity of participating nations to develop, negotiate, implement, monitor, and evaluate evidence-based and all-inclusive national health policies, strategies, and plans. 
This paved the way for number of policy discussions in African countries.

 

The paucity of evidence in the primary literatures reflects the fact that policy dialogue in health is young topic of inquiry. 
This research analyzes qualitative data from policy debates in Chad, Cabo Verde, Guinea, Liberia, and Togo in order to better understand the many kinds of power and how they manifest themselves in policymaking. 
Policymakers, researchers, and others can benefit from examining how power was exhibited in these discussions. 
It is critical for policymakers to understand how power was distributed in the discussions in order to better understand the outcomes and how to manage power more effectively in future dialogues. 
The paper employs Art and Tatenhove’s [4] power model, which is primarily reliant on the policy arrangement technique along with various power theories. 
The model is used to investigate and comprehend the various aspects of power, as well as the repercussions of their application in policy discussions. 
Given that theoretical models of power have never been employed in policy-making before, this research will help policy analysts better comprehend power. 
The Art and Tatenhove paradigm is helpful because it focuses on understanding the various elements of power.

 

On power and policy-making, there is dearth of literature. 
To explore how power features and influences policy discussions, we use the Arts and Tatenhove [4] conceptual framework on power dimensions. 
Power in policy-making, according to Arts and Tatenhove, has three tiers (Table 1). 
They claim that policymaking is dynamic process, that power is important to it, and that power is unavoidable and frequently used in any relationship.
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