Austerity policies implemented in Spain in response to the ongoing economic crisis may have detri... more Austerity policies implemented in Spain in response to the ongoing economic crisis may have detrimental consequences for the health of immigrant populations and for public health in general. A mixed-methods study by the Public Health Agency of Barcelona and the University of Michigan indicates that the Real Decreto-ley 16/2012 (RDL) threatens the health of individuals and the population, especially in the case of infectious diseases. The study sought to determine the percentage of foreign-born persons with an infectious disease who had an Individual Health Card (IHC) prior to the RDL and to determine whether foreign-born persons with an infectious disease in Barcelona encountered problems accessing health care after the RDL. Results indicate that immigrants used the IHC to seek medical attention for infectious diseases and chronic conditions. Results also show that 66% of respondents, including 54% of unemployed respondents, 3% of respondents working without contracts, and those in informal employment (9%), may be at risk of losing at least part of their health coverage. Universal health care access in Spain has been crucial for the control of communicable diseases among immigrant populations. Reducing access to a significant percentage of the total population may have deleterious effects on public health.
This chapter examines John Kingdon’s bookAgendas, Alternatives, and American Public Policy, consi... more This chapter examines John Kingdon’s bookAgendas, Alternatives, and American Public Policy, considered an alternative to the more technocratic existing theories of policy-making. It begins by summarizing what the book says about American public policy and looking at the interlocking innovations that made it so important. In particular, it analyses two political processes that differ from the better known aspects of politics: agenda-setting and alternative specification. It then turns its attention to the second conceptual innovation inAgendas: the three streams of policy, politics, and problems. The chapter also describes coupling and the window of opportunity as potentially the most theoretically difficult parts of the book. In addition, it discusses potential theoretical directions that would go beyond further replication ofAgendas.
ABSTRACT EU health policy debate is in a peculiar stage: on one hand, there is an established com... more ABSTRACT EU health policy debate is in a peculiar stage: on one hand, there is an established community of EU health policy experts, around since 1998 that understands a broad range of EU policies that might have major consequences for health care systems. On the other hand, there are the many managers and policymakers around the EU who know little about EU health policy and have seen few or no effects. I argue that it is because EU health policymaking has slow effects, and that the challenge is in influencing it before it has had important consequences. This article first reviews the policy issues, explaining why so much EU policy activity has produced so little concrete effect ‐ and why that situation will probably change. The establishment of a EU role in health care policy means that influence now will shape policies in the future. The second half of the article analyses the problems of coordination and attention that interfere with health care systems’ ability to identify the important issues. It argues that the problems are not so much in the management of complex knowledge as in the politics of knowledge: different interests that are contending forcontrol over the future of EU health policy.
ABSTRACT Since devolution, the United Kingdom has evolved not only in terms of political represen... more ABSTRACT Since devolution, the United Kingdom has evolved not only in terms of political representation but also in terms of the relationships between civil servants in each of its regions. In this paper, we present an analysis of the distinct professional and educational backgrounds of elite civil servants in Scotland, Wales, and Northern Ireland. Using a new database of professional biographies of top officials across all four jurisdictions, we assess the extent to which civil servants in these UK regions are organizationally and professionally distinct from one another and from those in the UK-wide departments. We conclude that despite organizational change, the recruitment, demographics, and career structures of top officials in the four jurisdictions are actually quite similar. Comparing our findings to earlier studies by others, it seems that this is because the Cameron governments appear to have overseen a resurgence of traditional civil servants.
ABSTRACT Political devolution allowed policy divergence around the UK. But England, Scotland and ... more ABSTRACT Political devolution allowed policy divergence around the UK. But England, Scotland and Wales must coexist within the UK, which means that the overarching rules of devolution shape their policy options. What friction emerges, what does it mean for health and how does the UK deal with it? This article, based on extensive elite interviewing, identifies 'bottom-up' issues in which health policy divergence creates intergovernmental friction and 'top-down' issues in which broader conflicts affect health. The rest of the article identifies and explains the mechanisms of coordination and dispute resolution,finding them probably inadequate to managing conflict.
Austerity policies implemented in Spain in response to the ongoing economic crisis may have detri... more Austerity policies implemented in Spain in response to the ongoing economic crisis may have detrimental consequences for the health of immigrant populations and for public health in general. A mixed-methods study by the Public Health Agency of Barcelona and the University of Michigan indicates that the Real Decreto-ley 16/2012 (RDL) threatens the health of individuals and the population, especially in the case of infectious diseases. The study sought to determine the percentage of foreign-born persons with an infectious disease who had an Individual Health Card (IHC) prior to the RDL and to determine whether foreign-born persons with an infectious disease in Barcelona encountered problems accessing health care after the RDL. Results indicate that immigrants used the IHC to seek medical attention for infectious diseases and chronic conditions. Results also show that 66% of respondents, including 54% of unemployed respondents, 3% of respondents working without contracts, and those in informal employment (9%), may be at risk of losing at least part of their health coverage. Universal health care access in Spain has been crucial for the control of communicable diseases among immigrant populations. Reducing access to a significant percentage of the total population may have deleterious effects on public health.
This chapter examines John Kingdon’s bookAgendas, Alternatives, and American Public Policy, consi... more This chapter examines John Kingdon’s bookAgendas, Alternatives, and American Public Policy, considered an alternative to the more technocratic existing theories of policy-making. It begins by summarizing what the book says about American public policy and looking at the interlocking innovations that made it so important. In particular, it analyses two political processes that differ from the better known aspects of politics: agenda-setting and alternative specification. It then turns its attention to the second conceptual innovation inAgendas: the three streams of policy, politics, and problems. The chapter also describes coupling and the window of opportunity as potentially the most theoretically difficult parts of the book. In addition, it discusses potential theoretical directions that would go beyond further replication ofAgendas.
ABSTRACT EU health policy debate is in a peculiar stage: on one hand, there is an established com... more ABSTRACT EU health policy debate is in a peculiar stage: on one hand, there is an established community of EU health policy experts, around since 1998 that understands a broad range of EU policies that might have major consequences for health care systems. On the other hand, there are the many managers and policymakers around the EU who know little about EU health policy and have seen few or no effects. I argue that it is because EU health policymaking has slow effects, and that the challenge is in influencing it before it has had important consequences. This article first reviews the policy issues, explaining why so much EU policy activity has produced so little concrete effect ‐ and why that situation will probably change. The establishment of a EU role in health care policy means that influence now will shape policies in the future. The second half of the article analyses the problems of coordination and attention that interfere with health care systems’ ability to identify the important issues. It argues that the problems are not so much in the management of complex knowledge as in the politics of knowledge: different interests that are contending forcontrol over the future of EU health policy.
ABSTRACT Since devolution, the United Kingdom has evolved not only in terms of political represen... more ABSTRACT Since devolution, the United Kingdom has evolved not only in terms of political representation but also in terms of the relationships between civil servants in each of its regions. In this paper, we present an analysis of the distinct professional and educational backgrounds of elite civil servants in Scotland, Wales, and Northern Ireland. Using a new database of professional biographies of top officials across all four jurisdictions, we assess the extent to which civil servants in these UK regions are organizationally and professionally distinct from one another and from those in the UK-wide departments. We conclude that despite organizational change, the recruitment, demographics, and career structures of top officials in the four jurisdictions are actually quite similar. Comparing our findings to earlier studies by others, it seems that this is because the Cameron governments appear to have overseen a resurgence of traditional civil servants.
ABSTRACT Political devolution allowed policy divergence around the UK. But England, Scotland and ... more ABSTRACT Political devolution allowed policy divergence around the UK. But England, Scotland and Wales must coexist within the UK, which means that the overarching rules of devolution shape their policy options. What friction emerges, what does it mean for health and how does the UK deal with it? This article, based on extensive elite interviewing, identifies 'bottom-up' issues in which health policy divergence creates intergovernmental friction and 'top-down' issues in which broader conflicts affect health. The rest of the article identifies and explains the mechanisms of coordination and dispute resolution,finding them probably inadequate to managing conflict.
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