Video lecture of chapter 1: The health policy framework
What is a policy problem?
- there must be a gap between the ideal world and current reality
- the reason for this difference should be unclear (anders is er geen probleem)
- there should be more than one possible solution to the problem
Policy has to do with : problem + end + means
policy = a purposive course of action followed by an actor or set of actors in dealing with a
problem or mattern of concern
Means: series of intended activities with certain consequences → instruments (to make
something in the world better/ or to change something, there are 4 instruments):
1) judicial = legislation
2) economic = subsidies/ taxes to change behavior of the population
3) communication = persuasion
4) modern: self regulation
Health policy triangle → simple relation model:
1. Actors
2. The content
3. The process
4. The context
Actors: individuals, organizations, groups, ‘states’
- Inside government: members of parliament, ministers, bureaucrats
- Outside government: groups that do not seek political power but may seek
influence. All kinds of groups:
civil society organizations: de kerk
pressure/ interest groups
non-governmental organizations
private sector companies
international organizations
social movements
Macro: Political → who steers the whole society
Meso: Institutional → people grouped in all kinds of institutions (university, consumer
association, greenpeace)
Micro: Societal → persons working out society
,Context:
Situational factors: ‘focusing event;, violent events (war, coup), earthquake, new disease
epidemic
Structural factors: political system, type of economy, technology, GNP (general income of
the state), demography, migration
Cultural factors: religion, traditional social values
International (exogenous) factors: interdependence among states, bilateral/ multilateral
aid
Process:
A cycle in which a problem is been taken up
Policy formulation = what is the problem and analyzing what should be the best solutions
Actually 5 policy steps in the making of policy.
1. Problem identification
2. Policy formulation: analyse what are the problems, what are the ins and outs and
what is the best solution.
3. Policy implementation: the decisions have to be worked out, have to implemented in
the world
4. Policy evaluation: you look back with all kinds of feedback rounds with what goes
rights and what goes wrong.
5. Feedback/ policy termination
, Content:
Content is actually what it is all about: ideas, numbers, experiences from patients or policy
makers etc.
- What is the issue?
- and how is it structured?
- What is the difficult part?
- Why is it not working?
→ doing interviews, focus groups
Video lecture of chapter 2: power and the policy process
Easton's model tells us how the government should work:
It requires all kinds of inputs: Demands from society, and support + resources.
The black box = the government (institutions of the government). This model is how it
should work. But how does it really work when power is evoked?
- Decisions are made by the one in the driver seat (health specialist, dictator, piloot,
military)
Outputs = goods and services
Rational model (simon)
Policy makers go logically through certain stages:
- Policy maker is faced with a particular problem
- Goals, values or objective are clarified and ranked
- Various alternative solutions are considered
- Costs and benefits of each alternative are investigated
- Each alternative and its costs and benefits are compared with other alternatives
- Policy maker chooses (but how will the minister will make a decision?) the alternative
that has highest net benefits
- In the driver seat there are the people who will make the decisions and have the
power to actualize specific things.
4 origins of power (Weber)