The Health Care Policy Process

The Health Care Policy Process enables the reader to develop a clear understanding of the scope and objectives of health policy studies, to analyze the extent to which policies can be changed or influenced by those involved at the different stages of the policy process, and to assess both the need and the scope for change. The author considers the relationship between planning and policy, looks at key concepts in analyzing health care issues, and examines some of the debates overshadowing today's health policy agenda.

List of Figures

x

(1)

List of Boxes

xi

(1)

List of Tables

xii

(1)

Acknowledgements

xiii

Part I What Are Health Policies and How Are They Made?

1

(33)

Introduction

1

(3)

1 Why Study Health Policy?

4

(6)

In summary

8

(2)

2 What Does Health Care Do for Society?

10

(10)

Debates in health care today

10

(3)

The value of health care

13

(4)

In summary

17

(3)

3 The Policy Process

20

(14)

What constitutes a policy?

20

(4)

Health care policies as systems

24

(2)

Policy and planning

26

(6)

In summary

32

(2)

Part II Studying Health Care Policies

34

(43)

Introduction

34

(1)

4 Approaches to Policy Studies

35

(9)

What kinds of policy study are possible?

35

(2)

Who should conduct policy studies?

37

(6)

In summary

43

(1)

5 Designing a Policy Study

44

(18)

How do we decide what to study?

44

(3)

Defining studies in priority areas

47

(3)

What kinds of evidence are available for policy studies?

50

(9)

In summary

59

(3)

6 Techniques and Methods for Policy Studies

62

(15)

Choosing methods

62

(1)

Asking the public

63

(6)

Asking experts

69

(3)

Techniques to assist the decision-making process

72

(1)

Choosing the technique or approach

73

(2)

In summary

75

(2)

Part III Analysing Health Care Policies

77

(24)

Introduction

77

(1)

7 Power

78

(10)

What fuels the policy making process?

78

(2)

Why discuss concepts of power?

80

(1)

Pluralism

81

(2)

Elite theory

83

(1)

Marxist approaches

83

(2)

Structuralist approaches

85

(2)

In summary

87

(1)

8 Professionalism and Bureaucracy

88

(13)

Professionalism

88

(1)

How dominant is the medical profession?

89

(1)

Health professionals in developing countries

90

(1)

Professionalism and complementary medicine

91

(1)

Bureaucracy

92

(2)

Do organisations today need bureaucrats?

94

(1)

How close is the bureaucratic model to real life?

94

(3)

Discretion

97

(1)

In summary

98

(3)

Part IV Key Issues in Health Policy

101

(66)

Introduction

101

(3)

9 Poverty

104

(13)

Ill-health and deprivation

104

(1)

Defining poverty

104

(4)

Wealth and poverty as determinants of health

108

(7)

In summary

115

(2)

10 Equity

117

(10)

What is equity?

117

(1)

Equity and social welfare

117

(2)

Equity in health care

119

(3)

Can equity be efficient?

122

(3)

In summary

125

(2)

11 Development

127

(14)

Views of development

127

(1)

Are things getting better or worse? An environmental perspective

128

(1)

Are things getting better or worse? A socioeconomic perspective

129

(2)

What can we do to make things better?

131

(1)

Modernisation theory

131

(1)

Welfare and redistribution approaches to development

132

(1)

Changing views about development

133

(2)

Globalisation

135

(1)

Privatisation: a global trend

136

(1)

Sector reform

137

(1)

In summary

138

(3)

12 Aid and the Health Sector

141

(10)

Aid within global relationships

141

(2)

Features of the aid process

143

(3)

Sustainability

146

(3)

In summary

149

(2)

13 Privatisation within the Health Sector

151

(16)

Privatisation: a global trend

151

(2)

Is there a case against the public sector?

153

(2)

What is the market environment for health care?

155

(2)

Does a market environment enhance democracy and community participation?

157

(3)

Does a market environment increase equity?

160

(1)

Does a market environment increase efficiency?

160

(1)

Does a market environment improve the services on offer?

161

(2)

In summary

163

(4)

Part V Can the Study of Health Policy Improve the Process?

167

(7)

14 Developing Health Policy

167

(7)

The way ahead

167

(1)

Developing policies for health for all

167

(4)

Evidence-based policy making

171

(3)

References

174

(9)

Index

183

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The Health Care Policy Process

Summary

Table of Contents

Supplemental Materials