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Lecture 5

HLTC43 Lecture 5.pdf

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Health Studies
Scott Sams

HLTC43 Lecture 5 Wednesday, June 5, 2013 10:00 AM Cue Column: Note-Taking Area: Interests and Influences Purpose: To introducethe forces shaping the development of health policy. Lessons from today’sclass: 1. Actors, ideas and structures interact to shape health policy. 2. A few key interests have an overwhelming influenceon the health policy debate. What are the major influences in the health policymaking process? • Levels of analysis ○ 3 diff levels 1. Broad, macro-level factors ○ E.g. political,economic and social forces related to:  The economic system  The state or government and related beliefs and attitudesof citizens □ Certainly the gov't anyway ○ Theory: political economy  Influenceon living conditionsand organizationsof HCS  Organizationof productionanddistribution of econ resources  Society has scarce resources □ These values influence howto allocate resources 2. Meso-level factors ○ E.g. governments, organizations,agencies ○ Theory: new institutionalism  Institutionsaffecting policy outcomes  How structures broader than you,constrain yourability to do things □ You want to make changebut you can't, so why?  Due to poli structure ◊ Example, lobbyistsw/ money will have more preferences 3. Micro-level factors ○ E.g. specific advocacy groups or interests  Try to advancea certain agenda  Health professionals} they have certain agenda as to what shouldhappen  Citizen activists  Corporateinfluences □ Pharma companies say don'tgive drugs for free }example ○ Theory: pluralism  All various interests come together as inputin policy making process □ No dominantgroup,any group can have their agenda realized ○ Micro-level factors embedded within, shaped by and result from meso-and-macro factors  Ideology governing howwe think, shapes institutionsand rules □ Those will structures opportunitiesin affecting policy change meso-and-macro factors  Ideology governing howwe think, shapes institutionsand rules □ Those will structures opportunitiesin affecting policy change  Goals can change the framework of system □ Ex. Pharma companies  Sell vaccine (capitalist approach) □ Wholesystem nested w/in ideology □ Hence "everything is political" ○ Understanding genesis of micro-level groups and their policy goals help us understand policy change or lack of change howthese affect health policy: Leichter’s framework • Situationalfactors ○ Shocks or upheavals create a ‘window” for policy change  Paradigmatic change, radical change ○ Example: 9/11} policy changes that you could'venever done • Structuralfactors ○ Changes in
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