The three phases involved in the policymaking process are formulation, implementation, and modification. The legislative branch carries out the formulation phase of the enactment of laws and creation and funding of health programs, and the balancing of the health policy with that of other domains of policy (Longest, 2015). The second phase is implementation, a mandate left to the executive branch of the government. Part of implementation is a proposal of legislation, approving and vetoing, and promulgating the rules and related regulations. The final phase of policy making is modification or interpretation. The judicial branch interprets both constitutional and statutory, developing case laws, preservation of rights, and dispute resolution (Kothari & Smith, 2022). This is consistent with all other government policies undergoing similar phases and interconnectedness.
Facilitating the three phases of policymaking in the health sector involves several stakeholders at each level. Starting with the formulation phase, stakeholders involved are those in the legislative branch who are members of Congress accorded the responsibility of enacting laws, the establishment of health programs, and creating a balance in the health policy in relation to other domains (Longest, 2015). Apart from Congress, the private sector is also instrumental in making health policies, such as the executives of health organizations regarding product lines, pricing, and the strategies that are involved in marketing. In the implementation phase, the stakeholders involved are those in the Executive branch who are involved in the proposal of legislation, approval, and vetoing of legislation and promulgating of the rules and regulations (Kothari & Smith, 2022). The stakeholders in this phase include government officials, agencies, and organizations in the operation of the government and its related programs. The final phase, the modification phase, involves the interpretation of the health policies by the judicial branch involving the courts, starting from the Supreme Court to other lower courts. The decisions and policies stemming from the judicial branch are authoritative because they bear direct and indirect influence on the decisions and actions of others. Three phases, i.e., formulation, implementation, and modification, are interconnected because the stakeholders in each stage are responsible for making health policies, directly and indirectly, affecting the decisions of others (Gamage & Abeysena, 2020). When the legislative branch enacts laws and policies, the executive branch must implement them fully. Future modifications to passed legislation and acts can be carried out in the judicial branch and become binding and authoritative.
The complicated nature of the health policymaking process denotes the possibility of issues and challenges. Today, the American healthcare system faces the challenge of implementing safe and evidence-based patient care, which has been sought over many years (Longest, 2015). Establishing the necessary policies and subsequent successful implementation is challenging, which is also a key issue facing the process of making health policies. Some of the health policies that have been established make the situation even worse, which is another issue that could be present. This is depicted by the formulation of ACA (Affordable Care Act) that intended to expand the population covered by Medicaid (Campos & Reich, 2019). However, the use of the emergency department increased with the use of Medicaid coverage, which depicts the opposite of what was expected. It is important that, in the future, a national health workforce policy is adopted which is diverse in its composition and fosters both private and public standards (Longest, 2015).
References
Campos, P. A., & Reich, M. R. (2019). Political analysis for health policy implementation. Health Systems & Reform, 5(3), 224-235. Web.
Gamage, A. U., & Abeysena, C. (2020). Health Technology Assessment (HTA) and health policymaking: A narrative review.Journal of the College of Community Physicians of Sri Lanka. 26(3). Web.
Kothari, A., & Smith, M. J. (2022). Public health policymaking, politics, and evidence. In P. Fafard, A. Cassola, & E. Leeuw (Eds.), Integrating science and politics for public health (pp. 59-74). Palgrave Macmillan, Cham. Web.
Longest, B. (2015). Health policymaking in the United States (6th ed.). Health Administration Press.