Health policymaking impacts people regardless of their own health situation, age, and other demographic characteristics. Given the enormous role of policies in everyday life, specialists in health and medicine are expected to understand the features of the policymaking process. The aim of this essay is to discuss health policymaking in relation to the level of government and stakeholders’ and the private sector’s contributions to the process.
The policymaking process is quite similar at three different levels of power in the U.S. According to Shi (2014), policymaking at the federal level involves the stages of policy formulation or agenda-setting, implementation, and modification. To be accepted and implemented on a nationwide scale, each piece of legislation is to undergo a well-established process, including public and presidential involvement, receiving feedback, and other components (Shi, 2014). The key feature of the policymaking process that exists at all levels is the use of the so-called democratic process (Michels & De Graaf, 2017; Shi, 2014). It means that final decisions regarding the proposed policies are not to be taken at the sole discretion, and the perspectives of all stakeholder groups have to be considered. Therefore, overall, the similarities between the three levels are presented by general approaches to decision-making.
Apart from similarities, there are differences between policymaking processes at different levels of government related to political structures and citizen involvement. At the federal level, policymaking is highly formalized and follows a strictly defined process every time. Even though non-federal governments typically use the same legislative process, there is much more variety at state and local levels, and the details of procedures may vary across states and cities (Shi, 2014). Unlike the state and federal organizations, local legislatures usually have one chamber instead of two, which narrows the set of people that can sponsor the newly-proposed laws (Shi, 2014). Concerning other differences, at the level of local governments, concerned citizens have more opportunities to participate in agenda-setting. For instance, in particular counties, citizens are allowed to write resolutions to be presented at local governmental meetings (Shi, 2014). In general, today, non-federal governments make multiple attempts to increase citizen participation in policymaking, and some state authorities are even obliged to consider citizens’ opinions when planning budgets (Huang & Feeney, 2015). Therefore, state- and local-level policymaking is less standardized compared to federal policymaking.
The private sector also contributes to policymaking in the field of healthcare. In particular, non-governmental organizations and their partners exercise their right to participate in health policy development by conducting research and critically evaluating the outcomes of policies that are already in use. As an example, the RAND Corporation, a non-profit health research center, organizes research and analysis activities to delve into U.S. citizens’ health problems and offer suggestions concerning new laws (Shi, 2014). The organization’s health division is concerned with studying particular public policy problems and carries authority in the policymaking community due to its high-quality reports.
Apart from sponsoring health research, the private sector’s role in policymaking involves protecting common citizens’ interests by concerting the efforts of different stakeholders. For example, non-profit organizations, such as the Pew Charitable Trust, act as intermediaries in the policymaking process by building coalitions of interest to facilitate the implementation of favorable policy decisions (Bushouse & Mosley, 2018). Private sector foundations are not allowed to take part in direct lobbying efforts, and it places some restrictions on their policymaking activities (Bushouse & Mosley, 2018). However, it is legal for them to develop partnership relations with representatives of power and provide governmental bodies with research findings and information on their activities and grants (Bushouse & Mosley, 2018). In other words, private sector organizations contribute to policymaking as intermediaries that initiate the exchange of ideas, disseminate research results, and create links between non-related interested parties.
In the context of healthcare policies, a stakeholder is any person or group that is impacted by their implementation or has particular interests associated with them. Stakeholders include interest groups comprised of individuals or entities that have a common opinion concerning health problems and the best policies to address them. The members of such groups may include healthcare consumers, provider organizations, specialists providing direct patient care, private and public insurers, and regulatory bodies (Shi, 2014). Additionally, medical and pharmaceutical manufacturing companies, research organizations, educational institutions, and healthcare businesses and corporations can also be regarded as stakeholders (Shi, 2014). Seeking input from all stakeholders is essential and beneficial since all of them have different experiences and can shed light on some underestimated aspects of health problems. For instance, public and patient involvement helps to create health services that meet local needs and give power to minority and marginalized groups (O’Connell, McCarthy, & Savage, 2018). Thus, health policymaking involves a large number of stakeholders, and it is critical to enable them to share their thoughts and concerns.
To sum it up, healthcare policymaking in the U.S. is based on democratic processes, the details of which may vary across states, cities, and counties. Organizations in the private sector contribute to policymaking by conducting health research and playing the role of an intermediary between disparate interested parties. Inputs from different stakeholders, including individuals and entities, should be encouraged to make new policies aligned with beneficiaries’ expectations and give a voice to underrepresented populations.
References
Bushouse, B. K., & Mosley, J. E. (2018). The intermediary roles of foundations in the policy process: Building coalitions of interest. Interest Groups & Advocacy, 7(3), 289-311.
Huang, W. L., & Feeney, M. K. (2015). Citizen participation in local government decision making: The role of manager motivation. Review of Public Personnel Administration, 36(2), 188-209.
Michels, A., & De Graaf, L. (2017). Examining citizen participation: Local participatory policymaking and democracy revisited. Local Government Studies, 43(6), 875-881.
O’Connell, S., McCarthy, V. J., & Savage, E. (2018). Frameworks for self-management support for chronic disease: A cross-country comparative document analysis. BMC Health Services Research, 18(1), 1-10.
Shi, L. (2014). Introduction to health policy. Chicago, IL: Health Administration Press.