Chapter Review Chapter 5, 6, 7 and 8



Describe in general terms the implementation phase of the publicpolicymaking process

The implementation phase of the public policy making process involvesputting the formulated laws into practice. Since concerned partiesmay be reluctant to change, implementation bodies see to it that allthe affected parties adhere to the new policies.

Who is responsible for public policy implementation?

The executive is responsible for public policy implementation.Executive agencies such as CMS are responsible for the federalimplementation of public policies. Such agencies ensure that theproposed policy is implemented in accordance with its formulationobjectives.

Discuss legislative oversight of policy implementation

The legislature plays an oversight role in the implementation ofpublic policies. The legislature ensures that the executiveimplements the policies in accordance with the set guidelines duringthe policy formulation stage. The oversight role of implementationensures that the executive does not implement only those parts of thepolicy that serve its interests.

Discuss rulemaking including the purpose of interest groups

The primary purposes of rule-making are to solve emerging problemsand make regulations. Interest groups review the proposed rulesbefore they are enacted into policies. During the review, they canmake suggestions to amend some clauses that may be exploitive orimplementable.


What does it mean to characterize policy implementation as publicmanagement?

Policy implementation is a function of public management because itinvolves several functions of management, such as human resources,information flow, and management of funds. The execution of thisstage requires skills in management.

Discuss in general terms the operation stage of policyimplementation

The operation stage of policy implementation involves conducting thespecific functions that the policy entails. It requires the effort ofgovernment employees and implementation agencies. For instance, ifthe policy recommends a reduction in insurance premiums, theoperation stage involves insurance companies lowering their premiums.

Discuss the effect of a policy on its own implementation

A public policy with clear objectives will positively affect itsimplementation. Policies with a clear hypothesis of how they shouldwork after implementation will also affect their implementationpositively. A policy with no clear objectives or hypothesis of how itshould work is like a roadmap with no destination.

Discuss the effect of implementing organizations on policyimplementation

The mandate, expertise, and resources of an implementing agency willaffect the implementation of policies. It would be impractical toassign an agency that operates within New York to oversee theimplementation of policies in the whole country.

Discuss managing an implementation organization. What competenciesunderpin successful management in implementing organizations?

Managing an implementation organization requires the designing of aproper implementation design. This task is best suited for managerswith a certain set of competencies. The management of an implementingorganization requires managers who can measure up to the expectedstandards, can learn to measure up to the expected standards, andpossess the competence to successfully design and execute theimplementation.


Discuss the distinction between policy initiation and policymodification

Policy initiation is the original idea to formulate a public policywhile policy modification involves altering an already existingpolicy due to the dynamism of the health sector.

Discuss the concept of incrementalism in public policymaking

The concept of incrementalism simply means that most public policymodifications are minor or on a small scale. A larger portion of thepolicy remains intact after the modification to avoid furtherunforeseen consequences. However, some modifications in the healthhave led to completely new policies with new consequences.

Describe modification in the agenda setting that precedes policyformulation

On the agenda setting stage, policy formulation is purely based onthe expected consequences of implementing the policy. It drawssuggestions and complaints from stakeholders and the formulators ofthese policies. At this stage, stakeholders with the most influencealways get their way.

Discuss how modification occurs in legislative development

At the legislative development stage, legislators debate and createamendments to the proposed policy. The stage relies on the knowledgeand research of the debaters to influence amendments to the publicpolicy.

Discuss how modification occurs in rulemaking

Modification in the rulemaking stage involves all the modificationsduring the agenda stage, legislative development stage and ascensionstage. These stages precede the implementation of the policy. Inother words, the modification depends on foreseen circumstancesrather than the actual effects of the policy after itsimplementation.

Discuss how modification occurs at the operation stage ofimplementing policies

At the operational stage of policy implementation, modification takesthe form slight changes in the implementation design. For instance,the implementation can change from beginning with high-levelhospitals to starting the implementation at low-level hospitals,after research shows that the latter is more effective.

Discuss the cyclical relationship between rulemaking and operationand how this affects modification

The cyclical relationship between rule making and operation existsbecause quite often, rulemaking does not take into account all theconsequences due to a proposed policy. The unprecedented consequencesduring implementation compel the need for modification. The changingdynamics of the health sector also institute policy modifications.

Discuss the role of oversight actors in policy modification

Oversight actors ensure that only the contentious issues aremodified. Quite often, during a modification, those who benefit fromthe law want to enjoy the benefits while those are negativelyaffected want to change the policy. The oversight actors aim atmaintaining fairness during the modification.

Discuss the role of policy analysis in policy modification.Include brief descriptions of three federal agencies that supportpolicymaking through policy analysis.

The role of policy analysis is to evaluate the performance of apolicy in order to propose appropriate modifications. Examples ofagencies include: RAND- experimental analysis of how the policies areworking in relation to expected consequences. GAO (GovernmentAccountability Office) – works under the request of the congress.Sees to it that the policies meet their objectives and offers adviceto congress members. CBO (Congressional Budget Office) – providingbudgetary analyses to the congress and conducts a cost- benefitanalysis.


Discuss the concept of policy competence

The public policy competence concept is basically the techniques andskills possessed by interested parties, to successfully analyze thepolicy making process and appropriately influence the policy.Interested parties in this context refer to individuals, healthcareorganizations and healthcare- related organizations.

Discuss the effect of health policies on individuals, health-related organizations, and interest groups

Most health policies aim at improving healthcare for the commoncitizen. The policies affect them positively. One particular exampleis the increase in the rate of acquisition of health insurance. Healthcare organizations are affected in that they are the providersof health services for which the policies are formulated. Although itis largely attributed to the laws of supply and demand, Publicpolicies are also a major contributor to the expansion of healthcareorganizations. Interest groups can be affected negatively orpositively depending on the nature of the policy. Policies thatenhance access to the services they provide fall under positive whilethose that inhibit access fall under negative impact.

What major areas do individuals share with health- relatedorganizations and interest groups regarding policies and thepolicymaking process? Why are organizations and groups than byindividuals?

The major shared concerns of individuals, health organizations andinterest groups are policies that negatively affect them orpolicymaking processes that do not involve them during theformulation stage. The last two stakeholders can circumvent thishurdle because they have more resources than individuals. They arealso organized and have a higher bargaining power to influencepolicymaking.

Discuss the benefits and limitations of organizations that conductanalysis of their public policy environments

The benefits accruing to an organization and interest groups thatanalyze policies include setting strategies for complying with thenew policies, identifying and assessing information about publicpolicy and the ability to classify complex information regardingpublic policy. However, the limitations are as a result of thefailure to foresee all the possible effects of the policies, and lackof resources for a complete overhaul of the system in order tomitigate the effects of the new public policy.

Who is responsible for the analysis of the public policyenvironment of an organization or interest groups? Who helps them?

Usually, interest groups and health related organizations set updepartments to analyze the public policy environment. Suchdepartments go by the name of government affairs. However, thedepartments can never be thorough in their analysis of the publicpolicy environment hence the help from other external agencies thatavail information regarding prospective public policies. An Exampleof such agencies is the Wisconsin Medical society.

Discuss the recommended steps in effectively analyzing the publicpolicy of an organization or group

When analyzing the public policy environment, the affected groupsshould look at the effects of a proposed policy on the demographic,economic, social, political, and cultural wellbeing of the society.The organizations should also look at the opportunities and threatsthat come with the policy and then create good strategies to takeadvantage of them. For the strategies to succeed, they will largelyrely on the organization design and performance.

Who is responsible for efforts to influence an organization’s orinterest group’s public policy environment on behalf of the entity?Who helps in the process?

Directors of departments that deal with public policies areresponsible for influencing policies on behalf of the entity. Withthe help of other directors and interest groups, they form biggergroups to increase their bargaining power in influencingpolicymaking.

Discuss the fact that influence in public policy environments is amatter of power and focus

In a war to modify or influence public policy, the party with morepower and focus on the subject usually wins. Interest groups have abetter chance of influencing public policy than individuals becausethey have more resources and are better organized. Interest groupshave power in their numbers.