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Development and Implementation

Development and Implementation. HAS 4320. Policies are authoritative decision made within government. Roles of the Three Branches of Government in Policymaking. Executive Branch Implements Policy. Legislative Branch Formulates Policy. Implements laws Proposes legislation

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Development and Implementation

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  1. Development and Implementation HAS 4320

  2. Policies are authoritative decision made within government Roles of the Three Branches of Government in Policymaking Executive Branch Implements Policy Legislative Branch Formulates Policy Implements laws Proposes legislation Approves or vetoes legislation Promulgates rules and regulations Enacts laws Creates and funds health programs Balances health policy with other policy domains Interprets laws Develops body of case law Preserves rights Resolves disputes Judicial Branch Interprets Policy

  3. Policy Formulation Policy Implementation Policy Modification

  4. How does a bill become a law? • Draw it… http://www.vote-smart.org/resource_govt101_02.php

  5. Developing legislation • Ideas • Drafting legislation • Introducing legislation • House and Senate • Conference Committee • Executive Action

  6. Ideas • Members of Congress • Individual Citizens • Health-related organizations • Interest groups • Executive branch

  7. Drafting Legislation • Only members can sponsor • Requires skill, knowledge, experience • Usually staff is involved • May be co-sponsored

  8. Introducing Legislation • Goes to committee(s) • Public hearings

  9. House/Senate Floor • Receives bills from committees • Debates • Sent to other chamber • If passed, differences are resolved

  10. Conference Committee • Usually ranking members • Differences ironed out • Conference report written/voted • Bill dies if no resolution

  11. Executive Action • Signs or vetoes • Doesn’t sign…then • If Congress adjourns

  12. Key Health Committees • Committee on Finance (Senate) • Committee on Labor and Human Resources (Senate) • Committee on Appropriations (Senate) • Committee on Ways and Means (House) • Committee on Commerce (House) • Committee on Appropriations (House)

  13. Value Economic exchanges in market transactions The Political Market Place Structurally and operationally, a political market is very much like an economic market. Sellers (Suppliers) Buyers (Demanders) Exchange Usually involves negotiation

  14. Interest GroupsGood or Bad? • 1st Amendment right “peaceably to assemble, and to petition the Government for a redress of grievances.” • James Madison’s definition of factions: “a number of citizens, whether amounting to a majority or minority of the whole, who are united and actuated by some common impulse of passion, or of interest, adverse to the rights of citizens, or to the permanent and aggregate interests of the community.”

  15. Policy Implementation

  16. Implementation • Not as much time • Responsibility • Effective implementation is key • Legislative oversight

  17. Regulation • Bureaucracy • Interested parties • Hearings • Federal Register

  18. Rulemaking • Implementation begins • Executive branch • Rules have legal effect • Ongoing • Changes • Interest groups

  19. Operation • Goals • Not vague • Not too restrictive • Implementing organizations • Designer • Strategist • Leader

  20. Operation (cont) • Inter-organizational relationships

  21. Challenges to Implementation • No enthusiasm • Vague instructions • Multiple goals • Rivalries • No cooperation • Too many people • Time • State and local agencies

  22. Health Bureaucracy • Department of Health and Human Services • Public Health Service • National Institutes of Health • CDC • FDA • Centers for Medicare and Medicaid Services (CMS)

  23. Three key groups… • FDA • FTC • OSHA

  24. Authority of agencies • Impossible to write a detailed law • Members don’t want to deal with it • Complex • Experimental • Agencies and Congress..some stories • Federal and State

  25. Policy Outcomes • Consequences • Policies and individuals • Policies and health-related organizations • Policies and interest groups • Input

  26. Steps in Analyzing Policy • Scanning • Monitoring • Forecasting • Assessing • Diffusing Page 137

  27. Summary • Development of legislation • Policy implementation • Regulations • Rulemaking • Operation • Outcomes

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