The central idea is that health policymaking extends beyond applying empirical knowledge, encompassing political factors such as ideology, commercial interests, and power dynamics. Its main goal is to equip the reader with the skills to analyze health policymaking as a political process.
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Description
This book is intended for students, teachers, and educators interested in health policymaking.
A key theme in the book is that health policymaking includes more than translating empirical knowledge about the determinants of health and disease into effective policy measures. A linear path from knowledge to health policy does not exist. Though undoubtedly essential, empirical knowledge on the determinants of life expectancy, quality of life, infant mortality, maternity death, health disparities, and other public health parameters is only one dimension of health policymaking. An instrumental view on health policymaking falls short because it neglects what may be called its political face. Health policymaking is not only a matter of applying empirical knowledge into practice but also the outcome of political contests, ideological beliefs, commercial interests, power, and standardized practices. This book aims to train students in analyzing the impact of these factors on health policymaking.
I wish to express my sincere appreciation to Maastricht University Press for generously supporting the publication of this book as an open-access resource, making it freely available to all those interested in health policymaking. This accessibility will undoubtedly contribute to a broader, more informed discourse on this crucial subject.
The book results from many years of teaching health policy analysis or the analysis of and for health policymaking. It could not have been written without the enthusiastic input of all the students I have met in my courses at Maastricht University. It is to them I dedicate this book.
I also thank Arianne Elissen, Daan Westra, and Harm Lieverdink for their comments on an earlier version of the book.
Maastricht, August 2023
Hans Maarse
Table of contents and contributors
PART ONE INTRODUCTION
CHAPTER 1 – THE PUBLICIZATION OF PUBLIC HEALTH
1.1 Introduction
1.2 What is public health?
1.3 Analytical model of public health
1.4 Success and failure of health policy
1.5 Health policymaking as collective action
1.6 The contested nature of health policymaking
1.7 The context of health policymaking
1.8 The future of the publicization of public health
CHAPTER 2 – HEALTH POLICY ANALYSIS
2.1 Introduction
2.1 What is health policy analysis?
2.3 Toward a model of health policy analysis
2.4 Overview of the book
PART TWO BUILDING BLOCKS
CHAPTER 3 – HEALTH POLICY
3.1 Introduction
3.2 What is public policy?
3.3 The double face of health policy
3.4 Health problems as a political construct
3.5 Structured, moderately structured, and unstructured problems
3.6 Problem resolution: a misleading concept?
3.7 Policy goals
3.8 Policy instruments
3.9 Policy paradigm
3.10 Policy narrative
3.11 Conclusion and suggestions for health policy analysis
CHAPTER 4 – HEALTH POLICYMAKING PROCESS
4.1 Introduction
4.2 Stage model
4.3 Rounds model
4.4 Crisscross model
4.5 Agenda building
4.6 Policy development
4.7 Policy Formation
4.8 Policy Implementation
4.9 Policy evaluation
4.10 Policy Termination
4.11 Policy path
4.12 Conclusion and suggestions for doing health policy analysis
CHAPTER 5 – ACTORS IN THE HEALTH POLICY ARENA
5.1 Introduction
5.2 Actors and Health Policy Arena
5.3 Policy networks
5.4 Policymakers
5.5 Experts
5.6 Interest organizations
5.7 Citizens
5.8 Producer organizations
5.9 Media
5.10 Judiciary
5.11 International Health Policy Arena
5.12 World Health Organization
5.13 European Union
5.14 Conclusion and suggestions for health policy analysis
CHAPTER 6 – THE GOVERNANCE OF HEALTH POLICYMAKING
6.1 Introduction
6.2 What is governance?
6.3 Governance gap
6.4 Governance and problem-solving capacity
6.5 Classification of governance rules
6.6 Governance models: modus of decision-making and compliance
6.7 Governance models: locus of decision-making
6.8 Multi-level governance models
6.9 Centralization and Decentralization
6.10 Global governance and its limits
6.11 Conclusion and suggestions for health policy analysis
CHAPTER 7 – HEALTH POLICY EFFECTS
7.1 Introduction
7.2 The concept of policy effect
7.3 The effectiveness of health policy
7.4 Side effects
7.5 Counterproductive effects
7.6 Distributive effects
7.7 Administrative costs
7.8 Health system performance
7.9 Political effects
7.10 Political trust
7.11 Conclusion and suggestions for health policy analysis
PART 3 MODELS IN HEALTH POLICY ANALYSIS 237
CHAPTER 8 – THE RATIONAL MODEL IN HEALTH POLICY ANALYSIS
8.1 Introduction
8.2 Synoptic model
8.3 Deliberative model
8.4 The observation-information-interpretation relationship
8.5 Sources and utilization of information
8.6 Evidence-based health policymaking
8.7 Contributions of evidence-based information to
health policymaking
8.8 Limits to the scientification of policymaking
8.9 Uncertainty and Risk
8.10 Strategies to deal with uncertain risks
8.11 Conclusion and suggestions for health policy analysis
CHAPTER 9 – THE NORMATIVE MODEL IN HEALTH POLICY ANALYSIS
9.1 Introduction
9.2 Purpose of the Normative Health Policy Analysis
9.3 Values
9.4 Norms
9.5 Mounting normative issues in health policymaking
9.6 The fact-value intersection in Health Policymaking
9.7 Moral dilemmas in public health policymaking
9.8 The politicization of normative conflicts
9.9 Conclusion and suggestions for health policy analysis
CHAPTER 10 – THE CONFLICT MODEL IN HEALTH POLICY ANALYSIS
10.1 Introduction
10.2 Conflict as Condition
10.3 Conflict as a Process
10.4 Types of Health Policy Conflicts
10.5 Conflicts with a common interest and without a common interest
10.6 The conflict-potential of health Policymaking
10.7 Impact of conflicts on the problem-solving capacity
of health systems
10.8 Politicization of Science
10.9 Conflict Resolution Strategies
10.10 Power
10.11 Power and information
10.12 The changing power balance in the health policy arena
10.13 Conclusion and suggestions for health policy analysis
CHAPTER 11 – THE INSTITUTIONALIST MODEL IN HEALTH POLICY ANALYSIS
11.1 Introduction
11.2 What is an institution?
11.3 Health system as an institutionalized system
11.4 Institutional pluralism and institutional incompatibility
11.5 Relationship between institutional structure and
health policymaking
11.6 Three institutionalist models
11.7 Explaining Institutional Continuity
11.8 Explaining Institutional Change
11.9 Models of gradual transformation
11.10 Conclusion and suggestions for health policy analysis
CHAPTER 12 – CONCLUSION
12.1 Why this book?
12.2 Building Blocks as starting-point of health policy analysis
12.3 Four analytic models