Section 2

I. Key Steps to Health Policy Formulation
The policy formulation process has become increasingly complex due to multiple constituencies to satisfy (individuals, business, providers); need to assess long range impacts ; and need to consider ethical dilemmas

7 Key Steps

A. Determine/ Reshape the purpose and objective of the policy (think back to analysis- problem identification)
- What do we want to do
- Who is the target audience
- How will we impact the problem
- Specify goals and objectives

B. Analyze what types of strategy is necessary to attain the goal
- Broad based or local- depending on the audience
- Be within ethical parameters
- Will environmental factors impact how we formulate policy i.e. recession will impact an employer's profits and their ability to offer health insurance

C. Analyze your approach given the environmental constraints
- What is the best case scenario
- What is the worst case scenario
i.e. recession and a business offering insurance

Best Case
- Recession subsides
- Business is strong despite recession
- Get a good deal on insurance
- No claims filed

Worst Case
- Business goes bankrupt as premium costs exceed profits

- Gather information on the environmental constraints

D. Ascertain resource utilization
- In formulating policy how much money will be expended
- Here do the forecasts ( i.e. with Medicare monetary forecasts were shockingly low and costs quickly exceeded them)
- How much human resource capabilities will be expended ( i.e. open clinics, have case managers, home care etc.)
- Spare and materials- with minimum utilization increased; this needs more beds and equipment
- Plan resource impacts on the future i.e.- now we have healthcare personnel shortages
- Will the future resources uphold the policy

E. Calculate the risks involved in Policy Alternatives
- In policy analysis- alternatives were determined and analyzed
- Here focus only on risks- this is more scientific whereas in the analysis step it is more dependent on brainstorming (a broad approach as we said in the last lecture)
- Focus on risks due to the fact that health care policies impact life!

F. Determine the acceptability of various "policy alternatives/ angles" to key groups (consumers, providers, lobbyists, govt.)- use this as a criteria for selecting alternatives
- Know the needs and expectations of these people (talk in depth to people)
- If on the state or local levels; how have other states or municipalities reacted to the same issue
- Know what strategies have been successful

G. Formulate a policy that is workable for the size of the group that it will impact and within what time frame
- Need key resources
- Need committed, competent people
- Need constant evaluation

This process allows the policy to be "specified"
- Formulation specifies/ narrows the analysis phase
- Readies the policy for operations/ implementation