The challenges of policy making, across national lines rest among the social strata of diverse societies and cultures. The vast landscape of cultures and societal differences between nations, countries, and governments is an important factor that helps characterize the way policy is shaped; and why it the outcomes are at times different and similar across identical objectives. The fundamental method of comparative analysis is something that I personally have mixed feelings about. On the one hand it gives you a good way to see how objectives fail and succeed from other perspectives. What I find troublesome is trying to implement any methodology gained from comparative analysis that is directly. What creates unique and progressive success is the ability to adapt and to be innovative. Comparative analysis should be used to create perspective which leads to innovation, at least in my opinion.
For instance from the readings I found the immunization article by Gary L. Freed quite interesting. He states, "the United States enforces behavior (immunization)for the public good through legislation, while the United Kingdom relies on the individual’s sense of responsibility to society to promote the same outcome," (Freed, 2005, pp. 755). This type of analysis is key because it exposes the legitimacy of policy decision making. Although you result in the same basic outcome, to provide people with accessible immunization, you do not have the same basic societal premise. That societal premise that is part of any group, country, nation, and or government is a driving factor which cannot be simply changed at any given time. This factor was developed over time, through experience, and culture. Thus for example, if either country analyzed the others and saw an opportunity for change, it could not simply integrate the change, I believe it would have to modify from its own perspective a way to innovate the change it wants within its own system, to attempt to produce the outcome it desires.
Within health policy it is interesting to see the different dynamics that influence changes or keeping constant in different nations. With the case of the U.S. and England I have a new gauge of comparative policy analysis. For example Adolino & Blake state, "The structural decentralization of decision making in the United States made it easier for opponents of reform to block new proposals that had considerable support...," (Adolino & Blake, 2010, pp. 276). Decision making within any one policy seems in many ways to always have an impact, or be impacted from some other arena, be it fiscal policy, or even politics, or cultural divides. Adolino & Blake state, "As we have seen in other policy areas, decision making and implementation are subject to a variety of influences beyond general public opinion and political trends," (pp. 276).
I suppose what I refer back to even more is that comparative analysis is just a tool to begin to design policy changes, or policy in general. I would still argue that it does not favor any type of direct implementation of ideas, yet a basis to reform ideas to reach desired outcomes.
References:
Adolino, Jessica R. & Blake, Charles H. (2010). Comparing Public Policies: Issues and Choices in Industrialized Countries. Washington D.C.: CQ Press
Freed, Gary L. (2005). Vaccine Policies Across The Pond: Looking At
The U.K. And U.S. Systems Health Affairs, 24(3), 755-757. Retrieved from http://content.healthaffairs.org/cgi/reprint/24/3/755
Your post brings up a really interesting point about governmental legitimacy. Much of what policy is accepted rests on what a particular nation believes about the role of government. In the US, there is a strong premise of government as a non-unique agent of action: the free market or family unit can do what government does, often more efficiently and in a more-timely manner. Healthcare is a prime example of that—we agree that vaccines are a good thing, we just cannot be convinced that it is the role of the government to administer or oversee their distribution.
ReplyDeleteWhile the US is taking grudging steps toward giving the government more say in healthcare, the UK is debating the merits of privatizing healthcare. The premise behind NHS is “healthcare based on need, not ability to pay,” but the current fiscal burden on the state is has inspired conservatives to push for privatization and remove the government as the chief provider of healthcare in the country. While healthcare would still be public and universal, the currently proposed reforms the bulk of the healthcare budget would be placed in the hands of general practitioners and multiple oversight committees would be dissolved, making way for a third, non-governmental party to ensure fair competition.
Unlike in the US, however, the proposed policies are meeting with passionate opposition from healthcare providers who claim that the less-government involvement reform would result in a " ‘market-based approach’" and warned that ‘the wish ... to improve the patient experience and provide more seamless, integrated care, seems at odds with many of the policies which will, inevitably, widen the purchaser provider split.’”. [1]In light of your discussion of supporting proposed healthcare reforms, it is interesting to see the current developments in the UK and how the what group backs the government’s legitimacy in this policy area will affect the final outcome.
[1]http://www.morningstaronline.co.uk/index.php/news/content/view/full/95903