(O.5) Policy Analysis

Question 1

Policy analysis

Answer 1

a process of multidisciplinary inquiry aiming at the CREATION, critical ASSESSMENT, and COMMUNICATION of policy-relevant information

• Multidisciplinary - many issues require evidence/thinking with multiple disciplines and backgrounds

Question 2

a technique used in public administration to enable civil servants, activists, and others to examine and evaluate the available options to implement the goals of laws and elected officials = ?

Answer 2

policy analysis

Question 3

Two types of policy analysis:

Answer 3

1. Retrospectivepolicy analysis
2. Prospectivepolicy analysis

Question 4

Retrospective policy analysis

Answer 4

= analysis OF

• Policy that exists or lack of policy (which is also a policy)
• Look backwards and analyze policies
• Descriptive; explanatory; often conducted by researchers

○ What was the nature of the policy?
○ Why did a policy make its way onto the agenda?
○ Did a policy successfully achieve its objectives?
○ Which policy instruments were used?
○ Who were the major actors who influenced the development of the policy and the policy process?

Question 5

Retrospective policy analysis examples

Answer 5

1. Westerns smoking policy
   ○ 2018: allowed in designated areas only
   ○ 2019: smoke-free campus
2. Nova Scotia introducing opt-out system for organ donation
   ○ Often need to opt in, default = not donating
   ○ Saskatchewan debating this but didn’t
   ○ Look back and see conditions why it did/didn’t get passed

Question 6

Prospective policy analysis

Answer 6

= analysis FOR policy

• Look ahead into the future
• Prescriptive (what we should do); typically requested by decision-makers considering whether to develop and introduce a policy; often conducted by government policy analysts

○ What are the policy options available to address the issue under consideration?
○ How should a given policy be formulated?
○ How should a given policy be implemented?
(resources)
○ How might a given policy fare if introduced now?
(Public backlash, success)

Question 7

Prospective policy analysis examples

Answer 7

• Ex. Should assisted dying be extended to minors?
  ○ Some argue against age restriction if one can comprehend consequences of decision
  ○ Can have options with restrictions

Question 8

Can prospective and retrospective analysis’ coexist?

Answer 8

Yer = If we’re trying to do a prospective analysis whether ought to for organ donations, might end up doing a retrospective policy analysis within that analysis to see what others have done, informing prospective analysis

Question 9

Why conduct a policy analysis?

Answer 9

• To systematically examine and evaluate the options available to pursue/implement the goals of laws and decision-makers
  ○ Typically so one track minded
  ○ Need to systematically explore all options
• To better ensure informed decision-making
• To better minimize bias
• To understand what has worked, what hasn’t worked, and why
• To better understand the process of policy-making
  (HOW to address issues in an effective way)

Question 10

Approaches for policy analysis

Answer 10

• Policy analysis triangle
• Stages heuristic
• Stakeholder analysis
• Health economic analysis
• Ethical analysis, legal analysis, etc.

Question 11

Policy Analysis Triangle

Answer 11

4 elements to think of for prospective and retrospective:
1. context
2. actors
3. process
4. content

Question 12

Policy Analysis Triangle: Content

Answer 12

= what makes up the policy

• What is the policy statement?
• What is/are the policy objective(s)?
• What are the means through which policy objectives will be pursued (i.e., policy instruments)?
  -What is the RELATIONSHIP between the responses to the above questions?
  - What reasons/evidence are supplied (explicit or implicit) to JUSTIFY responses to the above questions?

Question 13

Policy Analysis Triangle: ACTORS

Answer 13

= interest in issue, affected by it, play a role in policy

*Individuals
*Communities/populations
*Interest groups
*Organizations/corporations
○ Hospitals
○ Pharmaceutical companies
*Government bodies

(See stakeholder analysis)

Question 14

Policy Analysis Triangle: CONTEXT

Answer 14

= 4 factors

1. Situational factors
   ○ Ex. focusing events: wars, droughts, outbreaks
2. Structural factors
   ○ Ex. the political system (democracy vs. dictatorship, etc.), demographics, economy
3. Cultural factors
   ○ Ex. linguistic differences, ethnic minorities, religious commitments
4. Exogenous factors
   ○ Ex. international treaties/partnerships
   Beyond control but might exert pressure

Question 15

Policy Analysis Triangle: PROCESS

Answer 15

= stages heuristic
- policy evaluation
- agenda setting
- policy formulation
- decision-making
- policy implementation

Question 16

Stages heuristic

Answer 16

‘Stages’: stages of the policy process

‘Heuristic’: an approach to analysis

= ‘Stages heuristic’: an approach to policy analysis that breaks down the policy process into stages and analyzes each stage (4)

• Focuses on the process by which policies are initiated, formulated, implemented, evaluated (focus on all parts)

Question 17

4 stages of stages heuristic

Answer 17

1. Problem identification and issue recognition
   ○ Why did the policy get on the agenda?
2. Policy formulation
   ○ Who was involved in formulating the policy?
   ○ How was the policy arrived at and agreed upon?
3. Policy implementation
   ○ How were the policy’s objectives pursued?
   ○ How was the policy put into action/practice?
4. Policy evaluation
   ○ Did the policy achieve its objectives?
   ○What were the unintended consequences of the policy?

Question 18

Stakeholder (aka _____)

Answer 18

= actor
= an individual or group with a substantive interest in an issue, including those with some role in making a decision or its execution

*Affected, interest, role in decision

Question 19

Stakeholder analysis

Answer 19

= process through which those making policy or affected by it are identified and their likely position and levels of interest and influence are assessed

*Identifying all actors and identifying their levels of interests to put policy in place

Question 20

3 requirements for stakeholder analysis

Answer 20

1. Identify the policy actors
2. Assess their political resources (power, influence)
3. Understand their positions, interests, and level of commitment

Question 21

1 Identify the policy actors

Answer 21

• Consumer organizations
• patient groups

*Producer groups
- nurses, doctors, pharmaceutical companies

• Economic groups
• workers who may be affected, industries, companies with health insurance schemes

*Ideological groups
- political parties, researchers
- People have particular views and want policy to align with their ideologies (abortion)

Question 22

2 Assess actors’ political resources (power, influence)

Answer 22

• Level of interest and political resource they have to exert influence for/against policy

*Assess the power of each actor to influence the policy decision, through:
- Voting
- Material resources (e.g., money)
- Organizing people .etc

Question 23

3 Understand policy actors’ positions and interests

Answer 23

• Interests
  
  • economic effect on their interests; what do they have to gain or lose?

*Position
- supportive, neutral, opposed

*Level of commitment
Ex. how much of their resources/ influence are they willing to devote to pursuing their interests in the policy (i.e., to support or oppose it)?

Question 24

Health economics

Answer 24

= a branch of economics concerned with how scarce resources are allocated and used in the health system

Question 25

Health economic analysis
+ 2 example methods

Answer 25

Predominantly used to evaluate the efficient and effective use of resources to achieve health objectives

1. Cost-benefit analysis
2. Cost-effectiveness analysis

Question 26

Cost-benefit analysis

Answer 26

= compares the monetary value of resources used with the monetary value of resources saved or created

*Places a monetary value on lives and QOL

• Policy alternatives can be compared by the net monetary benefit

Ex. Should we fund cognitive behavioural therapy or nicotine replacement therapy to help people quit smoking?
- Examine the monetary value of all associated costs with the monetary value of all associated benefits
- Which has a greater net benefit?

Question 27

Cost-benefit analysis often done using ‘willingness-to-pay’ methodology, what is this

Answer 27

• Surveys/qualitative research to see how much one would pay for increase in QOL or years
• Put $ amount of benefit and compare to resources

Question 28

Cost-effectiveness analysis

Answer 28

= compares the monetary value of resources used with health effects (not reduced solely to $$)
* mortality rate, blood pressure

*How much will it cost to achieve particular health benefits?
○ Quality of life, life years .etc

*Can we spend the same amount on another intervention to achieve same/more health benefits?

• Ex. Should we add the HPV screening program to current Canadian screening practices?
  ○ Used screening program to sum up average # of life years saved
  ○ Use metric of life year to add price and compare

Question 29

Methods of Gathering information for policy analysis

Answer 29

1. Research evidence: data from researchers
   ○ Magnitude of the problem
   ○ Effectiveness of policy options
   ○ Stakeholder support for policy options
2. Policy documents: what others have done
   ○ Current policies, including objectives and means to achieve policy objectives
   ○ Values, assumptions, guiding principles
   ○ Policy approaches in different jurisdictions
   ○ Framing
3. Media/social media: look at sentiments of public
   ○ Problem framing
   ○ Stakeholder interest and support for policy options
4. Surveys/interviews/focus groups with stakeholders
   ○ Key stakeholders’ interests, positions, and levels of commitment