Identify one key piece of legislation that is currently making its way through the U.S. legislative process but has not yet passed or been enacted (*tip- go to the U.S. legislative database and search “Health”, “Health Policy”, “Public Health” or similar searches). Once you have selected a bill that has been proposed in response to a perceived public health problem, prepare a presentation outlining specifics and your analysis of the bill. reference this book: Wilensky, S. E., & Teitelbaum, J. B. (2022). Essentials of Health Policy and Law (5th ed.). Jones & Bartlett Learning.
Your presentation of your policy analysis, at minimum, should include the following:
Overview of the health problem: An overview of the public health problem to be addressed by the legislation. Discuss the problem and the number of people affected by it and by the proposed bill.
Severity of the health problem: Discuss the research behind the health problem. What would realistically happen if the bill is not implemented?
Overview of the bill: Please be sure to identify the name, number and author of the bill. You should include an overview of the proposed bill in terms of its specific provisions. Also be sure to state the current status of the bill. Has it been passed by the house? Is it in review?
Promises/Expected Outcomes: Identify the promoters and supporters of the bill (i.e. stakeholders). Describe what the supporters of the bill believe the bill will accomplish. What specific health outcomes the promoters claim will occur if the bill is passed? What communication channels are being (or should be) used for advocacy efforts? Discuss who is for the bill, and why?
Problems: Describe what individuals or groups oppose the bill, and why. Make sure to look at special interest groups (i.e. professional trade associations, industry groups, etc) to see what lobbying efforts they are making regarding the bill.
- Unintended Consequences: Discuss what unintended consequences could arise as a result of the passage of the bill (i.e. unanticipated events that could go wrong as a result of the bill). You may cite consequences suggested by others, or you can list the consequences you believe will result from the passage of the bill.
- Recommendation: What is your recommendation regarding this bill from a public health perspective? Make sure to support you’re your opinion with fact and research. What is your plan of advocacy (i.e., detail the advocacy efforts you can engage in to ensure the bill is supported, passed and/or implemented effectively)?
Policy Analysis OverviewIn this section we define what a policy analysis is, and then we review the purposes for developing one. In the following section, we provide a step-by-step process detailing how to create a written health policy analysis.Client-Oriented AdviceThe client is the particular stakeholder that requests the policy analysis, and the analysis must be developed to suit the client’s needs. (The client, for example, could be a policymaker who hires you, a fictional policymaker in an exercise developed by your professor, or an employer who asks you to analyze a problem.) In general, a stakeholder refers to an individual or a group that has an interest in the issue at hand. There may be many stakeholders related to a particular policy issue. Of course, the client requesting an analysis is also a stakeholder because that person or entity has an interest in the issue. However, to avoid confusion, we refer to the person or group that requests the analysis as the client and the other interested parties as stakeholders.Informed AdviceProviding informed advice means the analysis is based on thorough and well-rounded information. The information included in the analysis must convey all sides of an issue, not just the facts and theories supporting a particular perspective. If a decision maker is presented with evidence supporting only one course of action or one side of a debate, it will be impossible for the client to make a well-informed decision. In addition, to be effective in persuading others to favor the recommended policy, your client must be able to understand and, when necessary, refute alternative solutions to the problem.Public Policy DecisionPolicy analyses involve public policy decisions. A public policy problem goes beyond the individual sphere and affects the greater community.Providing Options and a RecommendationA key component of any policy analysis is providing the client with several options to consider, analyzing those options, and settling on one recommendation. In other words, a policy analysis is not simply a background report that identifies a variety of issues relating to a particular problem; instead, it gives the client ideas about what steps to take to address the problem and concludes by recommending a specific course of action.Your Client’s Power and ValuesFinally, the analysis should be framed by the client’s power and values. Framing the analysis based on the client’s power is fairly straightforward and uncontroversial: The options presented and the recommendation made must be within the power of the client to accomplish. On the other hand, the notion of framing an analysis according to the client’s values is more controversial. In most conceptualizations of policy analysis, including the one discussed later in this chapter, the process is roughly the same: Define the problem and provide information about it, analyze a set of alternatives to solve the problem, and implement the best solution based on the analysis (Patton & Sawicki, 1993, p. 3). As new information is uncovered or the problem is reformulated, analysts may move back and forth among these steps in an iterative process (Stone, 2002, p. 47). However, although there is general agreement that politics and values play a role in policy analysis, there is disagreement over the stage of the analysis at which they come into play.To understand this controversy, it is necessary to discuss two models of policy analysis: the rational model and the political model. The rational model was developed in an attempt to base policy decisions on reason and science rather than the vagaries of politics (Stone, 2002, p. 7). In the traditional rational model, the analyst does not consider politics and values. Instead, he or she should recommend the “rational, logical, and technically desirable policy” (Stone, 2002, p. 51). According to the rational model, the decision maker infuses the analysis with politics and values once the analyst’s work is complete.Professor John Kingdon and others have moved away from the rational model and toward a political model. Kingdon suggests that policy analysis occurs through the development of three streams: problems, policies, and politics (Kingdon, 1995). The problem stream is where problems are defined and noticed by decision makers. The policy stream is where solutions are proposed. These proposals may be solutions to identified problems, but they are often favored projects of policymakers or advocates that exist separate from specific problems that have garnered attention. Finally, the political stream refers to the ever-changing political mood. As a general matter, these streams develop separately, only coming together at critical junctures when the problem reaches the top of the agenda, the solutions to that problem are viable, and the political atmosphere makes the time right for change (Weissert & Weisser, 2002, p. 87).Kingdon’s approach discusses occurrences the rational model does not consider, such as why some problems are addressed and others are not, why some solutions are favored even if they are not technically the best approach, and why action is taken at some junctures but not at others (Kingdon, 1995). In addition, the rational model refers to only one cycle of problems. As Kingdon and others have noted, solutions to one problem often lead to unintended consequences that create other problems to be addressed, resulting in an ongoing policy analysis cycle instead of an event with a start and a finish (Weissert & Weissert, 2002, p. 260).Professor Deborah Stone also focuses on the role of politics and values in analysis (Stone, 2002, pp. 1–4). She argues that the idea of the rational policy analysis model misses the point because “analysis itself is a creature of politics” (Stone, 2002, p. 8). According to Stone, every choice, from defining a problem, to selecting analytic criteria, to choosing which options to evaluate, to making a recommendation, is political and value laden. As she states, “Rational policy analysis can begin only after the relevant values have been identified and .?.?. these values change over time as a result of the policymaking process” (Stone, 2002, p. 32). She contends that policy analysis should do the very things that the rational model does not permit—allow for changing objectives, permit contradictory goals, and turn apparent losses into political gains (Stone, 2002, p. 9). The goal of the rational model founders—to divorce analysis from the vagaries of politics—is simply not possible in Stone’s view.Having differentiated these models, we now return to our definition of policy analysis: an analysis that provides informed advice to a client that relates to a public policy decision, includes a recommended course of action/inaction, and is framed by the client’s powers and values. You can see that this definition follows Stone’s political model of policy analysis, requiring the analysis to be developed with a particular client’s values in mind. After reviewing the numerous examples provided in the following section, it will be evident that client values permeate all aspects of a policy analysis. Only after you take into account your client’s values, combine it with the information you have gathered, place it in the prevailing political context, and understand your client’s powers, can you make an appropriate policy recommendation.Multiple PurposesThe ultimate product of a policy analysis is a recommendation to a specific client about how to address a problem. However, a policy analysis has several other purposes as well. It provides general information necessary to understand the problem at hand and may be an important tool to inform stakeholders about a policy problem. In addition, the analysis may be a vehicle for widespread dissemination of ideas and arguments. Although your analysis is targeted to the client requesting advisement, it may also be used to inform and persuade other supporters, opponents, the media, the general public, and others. Finally, it will help you, the policy analyst, learn how to think through problems and develop solutions in an organized, concise, and useful way.Policy analyses can take many forms—a memorandum, an oral briefing, a report, and so on—and, correspondingly, have varying degrees of formality. This chapter explains how to construct a short, written analysis because it is a commonly used, highly effective, and often practical way to provide a policy analysis to your client. In addition, the principles embedded in a policy analysis can then be used in whatever other format(s) your client prefers. Whether you are aiding a governor, the director of a state program, the CEO of a private business, or any other decision maker, you often will not have the opportunity to discuss issues in person or for a significant length of time. Furthermore, given time pressures, the demands on high-level policymakers, the need for rapid decision-making, and the variety of issues most policymakers deal with, many clients will not read a lengthy analysis. That is why it is essential for anyone who wants to influence policy to be able to craft a clear and concise written analysis.
do the outline that address the question
The Four Key Tools of Policy Advocacy CampaignsAdvocacy campaigns typically rely on four key tools, all of which are used to help persuade the decision maker(s) to enact the desired policy change. These tools are as follows:Policy researchDirect lobbying and coalition buildingGrassroots and grasstops campaignsCommunications and media
ConclusionPolicy change is hard. Campaigns to change policy, whether through legislation or agency action, can take many years. It can be particularly challenging to advocate for policies to support communities with little political capital or for changes that are opposed by powerful industries. But the work is worth it. Well planned, thoughtful health advocacy is a critical strategy for improving the health of populations by addressing the systemic problems that challenge our public health and healthcare systems.You now have a basic understanding of what policy analysis is and an introduction to the tools necessary to analyze a policy problem. Additionally, thinking through the process described in this chapter should train you to evaluate your options when you become the decision maker. The checklist in Box 14.3 provides examples of what should be included in each section of a written policy analysis.Checklist for Writing a Policy AnalysisProblem IdentificationIs my problem written as one sentence in the form of a question?Can I identify the focus of my problem?Can I identify several options (but not too many) for solving the problem?BackgroundDoes my background include all necessary factual information?Have I eliminated information that is not directly relevant to the analysis?Is the tone of my background appropriate?LandscapeDoes the landscape identify all of the key stakeholders?Are the stakeholders’ views described clearly and accurately?Is the structure of the landscape consistent and easy to follow?Is the tone of the landscape appropriate?Does the reader have all the information necessary to assess the options?OptionsDo my options directly address the issue identified in the problem identification?Did I assess the pros and cons of each option?Did I apply all of the criteria to each option’s assessment?Are the options sufficiently different from each other to give the client a real choice?Are all of the options within the power of my client?RecommendationIs my recommendation one of the options assessed?Did I recommend only one of my options?Did I explain why this recommendation is the best option, despite its flaws?
Expert Solution Preview
One key piece of legislation currently making its way through the U.S. legislative process is the Medicare for All Act of 2021 (H.R. 1976) introduced by Representative Pramila Jayapal. This bill aims to establish a single-payer healthcare system in the United States, providing comprehensive healthcare coverage to all residents regardless of their ability to pay.
Overview of the health problem:
The public health problem that this legislation seeks to address is the lack of access to affordable healthcare for many Americans. Currently, millions of individuals in the U.S. are uninsured or underinsured, leading to delayed or inadequate healthcare services. This bill aims to ensure that everyone has access to the care they need, reducing health disparities and improving overall population health.
Severity of the health problem:
Research consistently shows that lack of access to healthcare services leads to worse health outcomes and higher mortality rates. Without the implementation of this bill, individuals will continue to face financial barriers to healthcare, resulting in delayed diagnosis and treatment of chronic conditions, increased hospitalizations, and even preventable deaths.
Overview of the bill:
The Medicare for All Act of 2021 (H.R. 1976) proposes a transition to a single-payer healthcare system, where the government acts as the sole insurer and provider of healthcare services. Under this bill, comprehensive healthcare services, including primary care, hospital care, mental health services, prescription drugs, and long-term care, would be covered for all residents of the U.S. The bill also seeks to eliminate cost-sharing requirements such as deductibles and copayments.
Current status of the bill:
The Medicare for All Act of 2021 (H.R. 1976) has been introduced in the House of Representatives and is currently in the committee review process. It has not yet been passed by the house.
Promises/Expected Outcomes:
Supporters of the bill, including healthcare advocacy organizations, progressive lawmakers, and grassroots movements, believe that the Medicare for All Act will achieve universal and equitable healthcare coverage. They argue that this bill will lead to improved health outcomes, reduced healthcare costs, and increased financial security for individuals and families. Supporters communicate their advocacy efforts through various channels, including community organizing, media campaigns, and lobbying efforts targeting lawmakers.
Problems:
Opposition to the Medicare for All Act primarily comes from those who are concerned about the potential costs and implications of implementing such a system. Special interest groups, including private health insurers, pharmaceutical companies, and some provider organizations, oppose the bill due to the potential impact on their profits and control over the healthcare market. These groups are actively lobbying against the bill, emphasizing potential disruptions to the current healthcare system and the potential for longer wait times for care.
Unintended Consequences:
If the Medicare for All Act is passed, there may be unintended consequences, such as an increased demand for healthcare services leading to potential strain on healthcare resources. Additionally, transitioning to a single-payer system may require significant administrative and logistical changes, which could pose challenges in implementation. It is important to carefully consider and address these potential consequences to ensure the successful implementation of the legislation.
Recommendation:
From a public health perspective, the recommendation regarding the Medicare for All Act would depend on a thorough examination of the specific provisions of the bill and the potential implications for the healthcare system and population health. Further research and analysis are needed to understand the potential costs, feasibility, and impact on access and quality of care under a single-payer system. It is essential to engage in evidence-based policy discussions and consider the experiences of other countries with similar healthcare systems.
In terms of advocacy efforts, supporting the bill would involve educating policymakers, healthcare professionals, and the general public about the potential benefits of a single-payer system. Engaging in public forums, organizing grassroots campaigns, and collaborating with like-minded organizations can help build support for the bill. It is vital to address concerns and misconceptions, provide evidence-based arguments, and emphasize the potential for improved health outcomes and healthcare equity under a single-payer system.
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