Review the following lecture:
Incrementalism
in Policy Making
Consider what you have learned about the Patient Protection and ACA, the uninsured population, health disparities, and programs and policies intended to improve quality of care and health outcomes while reducing healthcare expenditure. Summarize your thoughts on the future of healthcare given the provisions of the ACA—changes to Medicare and Medicaid, the individual mandate, etc.—and whether or not current efforts are sufficient to reduce disparities in healthcare and improve healthcare outcomes.
From the Internet, review the following:
Changes to public policy are often minimal; that is, they are modified slowly over time, in incremental stages. And, this is the preferred approach, particularly in healthcare. But, why? Incrementalism, which is the adjustment of existing policy through minor modifications over time, facilitates change in social, political, and economic circles. The preference for incremental change does not negate possibilities of wide-sweeping changes, such as with the Affordable Care Act (ACA), but this is not the norm. Incremental decision-making processes allow for greater collaboration and cooperation among stakeholders in the policy marketplace. As with the policy formulation and implementation stages, all three branches of the government participate in the modification stage.
Incrementalism
Advantages
Disadvantages
Is practical as the changes are small and reasonable, helps avoid conflict, and promotes changeEncourages shortsightedness with minimal changesIs simple and does not require specialized knowledgeDoes not support innovation or creativityIs flexible and allows for ongoing adjustments to be madeMay encourage waste by relying on a base of outdated policies
Legislators are tasked with the responsibility to identify policies in need of modification and to set a timeline for change. The executive branch, which may include presidents, governors, and mayors, helps to highlight necessary adjustments as they work through the implementation process. Finally, courts may determine modifications needed when policies appear in conflict with one another. Modification can also occur through the policy making process: formulation, implementation, and modification. Modification in the formulation stage hinges on the amendment of existing policies through agenda setting and legislation development. Modification in the implementation phase can occur through any of the four activities: designing, rulemaking, operating, and evaluating; however, most modifications occur during rulemaking and operating stages. Modification of policies establishes the cyclical nature of public policy making and allows for continual opportunities to align intention with observation.
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