Chapter 3: Theories of public policy Flashcards
Narrow view of health policy
Policies specifying how the health care system should be structured and run
Wide view of health policy
Policies in a non-health domain that can affect individual and population health
Levels of policy
Micro, meso and macro views
Micro view
Routine day-to-day government operations
Add to what already exists
Example of health care policy under micro view
Increasing funding to community health centres
Health-related public policy under micro view
Increasing housing subsidy amounts for tenants
Meso view
Operation of mid-level institutions like advisory boards or government departments
Expanding on what already exists
Example of health care policy under meso view
Creating a telehealth line
Example of health-related public policy under meso view
Changing eligibility requirements for social assistance
Macro view
Broad issues like the general shape of political systems and how power is wielded
How ideologies affect the functions of government
Example of health care policy under macro view
Creation of public private partnerships
Example of health-related public policy under macro view
Creation of a national daycare program
Main aspects of pluralism
Interest groups are the most important unit of analysis
Groups vie for power and access to achieve goals and objectives
State neutrally mediates diverse social and economic interests
What does pluralism suppose?
That all groups have equal access so policy output is a rational balancing of interests
What theory is the most influential in the Western societies?
Pluralism
What theory is the dominant understanding of advocacy groups trying to influence policy?
Pluralism
Two models of pluralism
- Easton’s model of the political system
- Kingdon’s policy stream convergence
Easton’s model of the political system
Shows the different inputs into the political system with the government at the centre being neutral to all interests in society
Kingdon’s policy stream convergence
Three streams
1. Problem identification
2. Policy proposals
3. Politics
Problem identification stream of Kingdon’s model
Government decides which problems require action
Policy proposals stream of Kingdons model
Interest groups demands
Political stream of Kingdon’s model
Political ideology influences which issues will gain acceptance
Politicians may vote against a bill if it doesn’t fit their political beliefs
Critiques of pluralism
Fails to consider role of political power or ideology
Too simplistic (obscures a complicated reality)
Political process is seen as consensual and conflict free (not true)
Government parties shut out perspectives of other groups
Doesn’t help understand health inequalities
New institutionalism
Some pluralist features but adds how institutions influence political discourse/debate and policy outcomes
Political institution
State and government structures that develop over time and persist
What can institutions be?
Formal rules of operation
Organizational structures
Standard operating procedures
What political views does new institutionalism focus on?
Micro and meso levels
Sub-types of new institutionalism
- Historical institutionalism
- Rational choice institutionalism
- Sociological institutionalism
Historical institutionalism
Traces how the past decisions of institutions shaped the future
Rational choice institutionalism
Economic position of political actors
Sociological institutionalism
How culture and norms have influenced policy change
Critiques of new institutionalism
Institutions constrain change, so they are not the best unit of analysis for explaining change
Minimizes degree of policy change possible
Imp to examine other social, political and economic forces
Political economy approach
Focused on economic, political and social structures that influence the distribution of power and resources in a society
**considers political power and the influence of political ideology on policy change
What is the political economy approach concerned with?
The mode of production
The mode of production
How goods and services are made and distributed
What type of mode of production do we use?
Capitalist
Feminist political economy
Considers how the political, economic and social organization of health structures opportunities for health for women
The main tenants of neoliberalism
- Markets perceived as most efficient in production and distribution of resources
- Societies are comprised of autonomous individuals
- Competition is primary source of innovation
Other aspects of neoliberalism
Governments should be small
Taxes should be low
There should be few government regulations
Goal of society should be economic growth
What approach is most similar to the views of pleuralism?
Consensus theory
What is a predominant belief about policy change in Canada?
Policymakers neutrally mediate the demands of interest groups
Commodification
Selling of goods and services including health care
Critical theory is to _______ , as political economy is to _____________.
Positivism, pluralism
Neoliberalism
Political ideology that favours the market as the vehicle for fostering economic growth and innovation
Role of citizens in pluralism
Join groups and organizations to gain power and influence political process
Access government through elections
What conception of society is pluralism consistent with?
Liberal- all citizens participate in political process
