Because there is a powerful connection between health policy and health, anyone professionally involved in the pursuit of health through any of the determinants shown in Figure 1.2 has a vested interest in understanding the health policymaking process—at both state and federal levels. An understanding of this process is important to developing a higher degree of policy competency. Much more is said about policy competency in Chapter 4, and in many ways this book is about enhancing the policy competency of healthcare managers and other health professionals. Suffice it to say in this chapter that policy competency is composed of the dual abilities to analyze the impact of public policies on one's domain of interest or responsibility and to exert influence in the public policymaking process.
The single most important factor in policy competency—including the ability to analyze the impact of public policies or to exert influence in the policymaking process—is to understand the public policymaking process as a decision-making process. Public policies, including health policies, are decisions, albeit decisions made in a particular way by particular people. Thus, understanding policymaking means understanding a particular type of decision making, including its context, participants, and processes.
As will be discussed throughout the book, the decision-making process through which public policies are made includes three tightly interwoven and interdependent phases: formulation, implementation, and modification. The phases do not unfold in neat sequence. Instead, they blend together in a gestalt of actors, actions, and, sometimes, inactions that yield policies. Figure 1.3 illustrates the closely intertwined nature of the relationships among the phases of policymaking.
This figure of the policymaking process emphasizes the continuous interrelationships and flows among the phases of the process. It also illustrates the cyclical character of public policymaking and shows it as an ongoing phenomenon, one without a definitive beginning or ending. In this view of public policymaking, policy formulation (making the decisions that are policies) is inextricably connected to policy implementation (taking actions and making additional decisions, which are themselves policies, necessary to implement policies). Neither phase is complete without the other. Because neither formulation nor implementation achieves perfection or exists in a static world, policy modification is a vitally necessary and complementary third component in the process. Modifications in previously formulated and implemented
Intertwined Relationships Among Policy Formulation, Implementation, and
Modification policies can range across a gamut from minor alterations in implementation to new rules and regulations used in implementation to modest amendments to existing legislation to fundamental policy changes reflected in new public laws. Chapter 3 describes this process in more detail.
Increasingly, policy competency is important to those who wish to be effectively involved in the pursuit of health. Within the context of the political marketplace, where public policymaking occurs, many participants seek to further their objectives by influencing the outcomes of this process and by more accurately predicting the outcomes of the process. Policy competency is an important ingredient for success in this arena.
An adequate degree of policy competency is necessary to understand what might result from the policymaking process that could affect a vital interest and to effectively participate in the policymaking process. Through competent participation, one can exert influence on future health policies and, thus, on the determinants of health and ultimately on health itself. This competency is built on a base of understanding of the public policymaking process, which is modeled and discussed in Chapter 3. First, however, in Chapter 2 a fuller consideration is given to the critical relationship between public policy and the pursuit of health.
Good health is defined as "a state of physical and mental well-being necessary to live a meaningful, pleasant and productive life. Good health is also an integral part of thriving modern societies, a cornerstone of well performing economies, and a shared principle of European democracies," which can
Was this article helpful?
Achieve the Fitness and Wellness for You that you have always wanted by learning the facts so you can take the right steps to maximize your health. Learn How to Achieve Real Fitness and Wellness for a Healthy Body, Mind and Spirit to Improve Your Quality of Life in Today's World. Receive Valuable Information to Discover What Really Matters and What Actually Works in Finding Genuine Wholeness for All Aspects of Your Being.