As the model in Figure 3.2 illustrates, the policymaking process is distinctly cyclical. The circular flow of the relationships among the various components of the model reflects one of the most important features of public policy-making. The process is a continual cycle in which all decisions are subject to subsequent modification. Public policymaking, including that in the health domain, is a process within which numerous decisions are reached but then revisited as circumstances change. This cyclical nature of health policymak-ing, in which decisions are made and then revisited, can be seen in the pattern of Medicare policy presented in The Real World of Health Policy: Medicare Revisited—Again and Again.
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