Health Policy by the Administration of Aging

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Table of Contents

Introduction
Main body
Ideology of Implementation
Conclusion
References

Introduction

The establishment of laws marks the crossing over from policy formulation to policy implementation. The national organization Alas Strategic Plan, 2003-2008 exemplifies the implementation phase of Longest’s model in that it has structured rulemaking and operation into a cyclical feedback process. As such, when formulated rules are operationalized, gaps and new knowledge are fed back to the rulemaking activity to amend regulations.

This is a continuous cycle as depicted in the model. The five-year strategic plan of The Administration of Aging (AoA) exemplifies the importance of having a rulemaking stage during the implementation of national aging health policy. Formal rules have been developed into five broad strategies or regulations. It appears that you are aware of the vital need to use rulemaking as a starting point to health policy implementation in order to bring about the intent of the policy.

Main body

The regulations stipulate what needs to occur for strategic goals to be achieved; for example, Goal 1 stipulates that there be an “increase” in the number of older people accessing health supports. The AoAs strategic goals are constructed to indicate how human, financial and other health-related resources will be managed to make the goals of the policy possible. The Longest model stipulates that the implementation phase of the policy-making process is essentially about management. Each strategic goal of the AoA has several objectives, and each objective states an aim to be achieved toward meeting the strategic goal (e.g., “strengthen AoAs capacity to provide information…”).

The second step in the implementation of public laws is the operation of the policy. How to operationalize the processes needed to achieve the outcomes. This normally includes assessment and measuring activities according to Longest’s model. The AoA incorporates evaluation and monitoring regulations within its operationalization of goals; for example, Goal 1, Objective 1.2, Strategies: “Conduct analysis of research findings…”.

That the AoA plan includes the potential for modification parallels Longest’s contention that policies exist in a dynamic world and need to be able to adapt to changes in other phases due to external factors. Additionally, the AoA strategic plan reflects the political nature of Longest’s model in that various stakeholders is involved in determining the viability of the operation of the rules made. The Assistant Secretary for Aging coordinated the Administration of the strategic plan.

The implementation phase of the strategic plan exemplifies Longest’s depiction of greater involvement of executive branches of government. The rule-making portion of the plan illustrates the complex task of breaking down the simplified laws into distinct elements that each target achievement of that law being implemented (Greener, 2006). The plan reflects the difficulties in juggling priorities and ensuring all stakeholders are accounted for during this interpretation process. In turn, the operationalization of strategies to achieve the objectives of each overriding strategic goal provides a comprehensive description of how rules will be applied in the real world of national health.

Overall the AoA strategic plan mirrors the circular flow of information that Longest emphasizes as critical to policymaking, in that the plan is able to be continuously modified as circumstances change. In this way, the plan demonstrates the open system nature of the policy-making process. The format and content of the AoAs strategic goals present a complex managerial process, reflecting the national scope of the aged care policy. Despite the huge endeavor that has been undertaken, the AoAs strategic plan exemplifies Longest’s claim that the scale of the project does not negate his model’s requirement for the implementation phase to be a two-prong process;

rulemaking;
operation.

As such, AOA demonstrates that although complex, the implementation process is comprised of distinct hierarchical stages that are interrelated. Ultimately, changes to public health policy need to be implemented effectively in order to achieve expected health outcomes.

Ideology of Implementation

Ideology plays a large role in Longest’s model given the political and moral concerns involved in the policy-making process. The model illustrates how USA political leaders approach policy issues, such as seeing them not as a rigid solution, but rather a dynamic and flexible set of strategies that demonstrate values upheld within the community at the time (Kronefield, 1997). For example, the AoA strategic plan reflects the 21^st-century value of all individuals, regardless of age.

Also, the plan acknowledges the social and health concerns of the aged as a marginalized group within the community. Given the “graying population” in the industrialized world, it is pertinent that the AoA plan is developed to account for an increasingly older population. The Longest model provides for ideological inclusion in the implementation phase by delineating two tasks that feedback into each other. Rulemaking is modified by operations, creating a flexible process of implementation that reflects the ideology of a rapidly changing physical world and social values. The feedback of the cyclical process allows for social changes in values and expectations to modify rules as needed.

Longest’s implementation phase depicts the significant influence of political ideologies on the processes of rulemaking and operation. The political characteristics of the process of policymaking are not explicit in the model but are implicitly illustrated. This illustrates how the overall policy-making process is not a rational thinking activity but is subject to personal biases and agendas of those who are in power, and of those who will be the targets of the policy.

As such, the drive behind policymaking, according to the Longest model, is not to simply find the best solutions at providing a national health system using debate and other public forums of discourse. Similarly, policies are not rationally chosen on their merit of being able to best support national health aims. Hence, interest groups’ preferences, bargaining power of stakeholders, vote trading, and other personal biases are all external factors that act upon the policy-making process, influencing the final policy decisions as to how to implement public health laws.

As such, it appears that Longest has acknowledged the lack of empirical research to drive decision-making at the executive level of government, instead of policy formation is influenced by the personal agendas of those in power.

His model accurately shows, in this case, that not all the stakeholders are acting in the best interest of all affected by national health policy. However, the self-interests of stakeholders are regulated in Longest’s model by the inclusion of the feedback cycle which depicts the evaluation of rules and regulations by those affected by them, to allow for modification. The model is also an example of how ideologies of different stakeholders are accounted for by allowing a two-step cyclical implementation phase so that self-interests and public interests can be assessed, commented upon, and incorporated into the policy where suitable.

Conclusion

In this way, it can be argued that ideology will at times replace good judgment by policymakers. As such, suggests Longest’s model, government policymakers determine that an assortment of laws and measures are needed to specifically shape the composition, size, and rates of change of national health. Whereas in the past it was the government that took sole responsibility for the provision of public services duties (e.g., provide hospitals), the impact of these public duties were generally were subsidiary to an intended purpose (e.g., national public health).

Longest illustrates how the harnessing of government powers through policymaking to achieve goals has developed a new relationship between government and citizens, which requires the inclusion of social values and expectations.

References

Greener, I. (2006) Comparative health policy. Public Administration, 84(2), 500-511.

Kronenfeld, J. J. (1997). The Changing Federal Role in U.S. Health Care Policy. Boston: Praeger/Greenwood Publish.

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Health Policy by the Administration of Aging

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