Chapter 5: Influences on public policy Flashcards
Leichtner’s framework- factors that impact policy change
- Situational factors
- Structural factors
- Cultural factors
- Environmental factors
Situational factors
Sudden or violent events that are transient or one time
Allows for policies not previously possible
Examples of situational factors
9/11, Hurricane Katrina, World War II, COVID
COVID as a situational factor
Allowed for policies such as stay at home orders, face masks and travel bans to be put in place
Structural factors
Permanent and includes changes in political leadership, demographics and social characteristics
Examples of structural factors
Extent to which a country is urbanized and age distribution of the population can affect the health care services available ex. more old people require more LTC and palliative care
Cultural factors
Customs, arts, social institutions, symbols, language, norms, values and achievements of a particular nation, people or other social group
Cultural factor example 1
Attitude towards government and the role of the state
- if population doesn’t trust the government, they won’t vote in election
Cultural factor example 2
Religious teachings
- Using christian faith towards political advantage
- abortion
- same sex marriage
Environmental factors
External or international factors
Environmental factors examples
National American free trade association (NAFTA)
Loss of manufacturing jobs in US, more in China
Example of an environmental factor that impacted Canadian public policy
Surging cases of COVID-19 in US
Limitations of Leichtner’s model
Lacks an explanation for how structures and situations influence policy
Doesn’t consider role of civil society actors or political ideology
Easton’s framework- inputs
Values
Demands
Support
Resources
Government and inputs
Governments select which one of these inputs they will afford greater attention to then make policy
Values examples
Medicare
Demands
Expressed wishes of groups who desire particular policies that address their own objectives and interests
Demands example
Black lives matter
Support
Public acceptance of these demands
Resources
Means available to governments to address the demands made by these interest groups
Resources example
Money/tax funding
Easton’s model- government institutions
Welfare states
- social democratic
- (Neo)liberal
- conservative
- latin
Social democratic welfare state ideologic inspiration
Equality
- reduce poverty, inequality, unemployment
Social democratic welfare state organizing principle
Universalism
Social democratic welfare state focus of the programs
Resources
Social democratic welfare state central institution
State
Liberal welfare state ideological inspiration
Liberty
- minimize government interventions, disincentives to work
Liberal welfare state organizing principle
Residual
- focus on the basic needs of the most marginalized citizens
Liberal welfare state focus of the programs
Needs
Liberal welfare state central institution
Market
Easton’s framework- outputs
Goods and services provided by government (health care)
Macro, meso or micro level policies
What do Easton and Leichtner’s frameworks leave out?
Disagreements or conflict btwn advocacy groups
Key influences on the public policy process
Civil society
Advocacy groups
Health coalitions and professional associations
Media
Political ideology
Corporate sector
Civil society
Politically engaged citizens, professional policy analysts, associational networks that attempt to influence public policy decisions
ex. Heart and stroke foundation
Civil society examples
United Auto Workers, Black lives matter social movement, Anglican church of Canada
Advocacy groups
Groups that advocate for a particular issue
Advocacy groups examples
David Suzuki foundation, Canadian snowbird association
Health coalitions and professional associations
Ontario AIDS Network, Canadian Nurses association, Canadian Medical Association
The Canadian health coalition belief regarding health care
Believe in the importance of maintaining a public approach
The Canadian Medical Association beliefs regarding health care
Stress a private approach
Media focus
Wait times for health care services rather than social determinants of health
Media examples
Canadian broadcasting corporation, the globe and mail, facebook
Political ideology
Social acceptance of one political ideology over another can shape policy development
Political ideology example
Neoliberalism, socialism, fascism
Corporate sector
Advocates for greater private involvement in all aspects of public policy especially w regard to health organization and delivery
Focused on generating profit
Corporate sector example
Royal bank of Canada, Chamber of commerce
US affordable care act (Obama care)
Requires all Americans to purchase their health care insurance from the private health care insurance industry (individual mandate)
Requires all employers with a certain number of employees to provide health insurance (employer mandate)
Goal of Obama care
Ensure all Americans have health insurance
What does Obama care fix for American health insurance
Outlaws screening people for pre-existing health conditions
Removes ban on annual and lifetime coverage caps
Removes cap on annual out of pocket costs
Which group was most opposed to Obamacare’s individual and employer mandates?
Neoliberal politicians
What type of welfare state is Canada?
Liberal
- provides least support and security to citizens
Who has stronger influence on public policy making?
Physicians rather than allied health professionals
- they favour private approach
Critique of Easton’s model
Focuses too primarily on state institutions and too little on categories of actors and other influences on the political system
Fails to capture conflict
How do Americans pay for their health care?
Private insurance
Medicaid
Medicare
Veterans administration
Uninsured/out of pocket
Medicaid
Assistance program that provides health insurance to low income Americans of all ages
US Medicare
Provides health insurance to seniors aged 65 years and over and people w disabilities
