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Generally, policies are the structural processes that determine the way the government acts on various matters that touch on the welfare of the citizenry. In the healthcare sector policies often, refer to the approaches that guide the government in the making of decisions concerning the provision of health care services for the citizens. The formulation of the health polices in the United States is generally governed through a sequence of actions that ultimately yield a workable policy framework (Gerston, 2010). The policy framework is then integrated within the system of government so that it serves as the reference points for all future actions and plans of the sector. Generally, the processeses that determine the formulation of a policy include building of the agenda, the formulation of the policy, policy implementation, evaluation, and policy termination (Gerston, 2010).
The agenda building stage in the policy making process usually begins with the need to deliberate on an existing or emergent problem. A certain issue or phenomena results and causes strain on the society, thus necessitating sections of the society to deliberate on the possible ways of mitigating the resultant adverse effects. One of the most sensitive issues in any society is the health care sector (McLaughlin, 2004). It is also the most cost intensive sector. Therefore, this sector will demand a multi-spectral approach that would address it in accordance with the complex needs of the society.
In the United States, the issue of insurance cover for the citizenry has often yielded debates regarding the best possible approach (McLaughlin, 2004). The agenda building stage for the health care sector often involves the deliberation on the balance between the costs and the provision of quality health care services to the citizens. This provision is considered a fundamental basic right (McLaughlin, 2004). Over the years, the agenda building stage has influenced varying perspectives regarding the best possible approach that would offer appropriate balance between care and costs.
The formulation and adoption stage in the policymaking process entails the designing of some specific approach that would constitute the structures and mechanics of addressing the identified matter or problem (Gerston, 2010). Various institutions may be involved in the formulation and adoption stage of the policy. These institutions may include lobby groups, courts and congress. At this stage, the various organs and institutions that are engaged in the process of formulating and adopting the policy tend to adopt contradictory approaches that suit their specific interests. At the advanced stage of the process, a bill may be presented before Congress. Alternatively, a specific regulatory agency may assume the task of drafting the proposed laws. These processes generally prepare the ground for the adoption of the policy (Gerston, 2010).
The final adoption or rejection of the policy will be determined by the decision of the Congress. The Congress may adopt or reject the bill. The passage of the bill would imply that the regulations and rules designed at the earlier stages become fully functional. However, the Supreme Court may intervene to determine the fate of the bill in case any contentious issues are brought before it for final determination. After the formulation and adoption of the policy, the next stage becomes its implementation. The implementation process of the policy is placed under the charge of specific bodies that lay down the structures and operational details that ensure the workability of the policy (Barnes, 2004). This process usually involves bodies and agencies that have been known to deliberate on adoption processes of the policy. The earlier stages of adoption and formulation do not provide the mechanics of the implementation of the policy (Barnes, 2004).
Generally, this process would involve the setting up on rules and procedures that would customize the policy. Usually, the process would entail the need for integrating the details of the policy within the existing framework and systems in a way that would not yield operational conflicts. Sometimes the implementation process turns out to be problematic due to the mismatch between the details of the policy and the existing framework where it needs to be absorbed. It is because of this reason that sufficient deliberation and positive criticism need to precede the adoption process in order to streamline it within the existing structures. A second challenge that often faces the implementation process of the bill concerns the compliance levels by the stakeholders (Barnes, 2004).
Stakeholders may tend to adopt approaches that are contrary to the letter and spirit of the policy. Certain sections of the society may adopt critical approaches to the policy thus rendering its workability problematic. Lobbyists, interest groups, and political opponents may pose compliance problems at the implementation stage of the policy (Barnes, 2004). However, the streamlining of the policy into the official frameworks of the government makes it obligatory for everybody across the board to adopt its requirements and specifications. It becomes binding as long as no group or individual challenges its legitimacy before the Supreme Court.
The next stage after the implementation stage of the policy is the evaluation and termination stage. The evaluation of the policy is anchored on the need to determine the levels of the policy’s efficacy in line with the specific objectives, for which the bill was originally designed to address. The evaluation of the bill is usually conducted within the broad concept of the cost-benefit analysis. Stakeholders will tend to be critical of the bill if the evaluation reveals that the cost of maintaining the policy is not commensurate with the attendant benefits (Gerston, 2010). However, evaluation stages of policies are often faced with the challenges of method, because different methods and approaches will yield contradictory perspectives regarding the efficacy of the bill.
Usually, the merits of evaluating the policy are marred with vested interests from the political class, groups, and individuals with stakes in the policy. Health policies are some of the most divisive policies in the United States because of the conflicting perspectives between the government and insurance providers. The contention between these two parties is explained by the fact that the government will aim to include all its citizenry within the insurance umbrella, whereas the insurance groups would want policies that shield them from every possible risk or loss. The termination of policies is often a rare occurrence. However, certain developments may arise to make a particular policy obsolete or expensive. Generally, technological innovations may render certain policies problematic. When such situations arise, the policy makers will initiate debate that could lead to the eventual overhauling of the policy and replacing it with one that suits the interests of the stakeholders (Gerston, 2010).
Policies may also be terminated due to political will. Politicians may assume office on the promise of bringing about specific changes in the healthcare sector. Alternatively, pressure groups may initiate campaigns that could culminate into the changing of certain policies, which they deem to be unproductive to certain interests. Certain policies may be made in such a way that they only require strategic revisions in different political or ideological dispensations (Gerston, 2010). They could also be structured to align them with the fluid nature of social realities. Makers of policies often take precautionary measures to include flexible structures that would guarantee the survival of the policies in different political, ideological, and social realities. Policies that combine prevailing conditions and the likely scenarios tend to outlast those that are generally modeled on transient stimuli.