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At least 145 records · Page 8Linked to original sources
PubMed1979

Evidence and proof in making policy decisions.

General dietary guidelines for the public are established to minimize risk. Recommended intakes of essential nutrients--the RDAs--are established at levels believed to be substantially above those required by most individuals in order to minimize the risk of deficiency of those with highest requirement. Such levels of intake do not benefit most individuals, cannot be proved to be correct since few individuals benefit, may mislead some individuals as to the benefits to be derived from such diets, but are defensible on the basis that they are probably helpful for a few and impose no health risk. They do impose unnecessary food selection for most people. Recommended intakes of fat, cholesterol, sugar, salt, toxic materials, etc.--food constituents that impose risks at higher intakes--must also be developed to minimize risk. No advantages are claimed for high intakes of the above. Abundant evidence, epidemiologic, clinical, and experimental, identifies high intakes as imposing substantial risk. The nature of chronic diseases associated with excessive intake, which may require 10-30 years before effects are manifest, precludes adequate experiments to definite the results associated with dietary change. The only rational position that can be taken is to recommend reduced intakes consistent with various practical restraints.

Decision Making↗
PubMed2003

Human cloning laws, human dignity and the poverty of the policy making dialogue.

BACKGROUND: The regulation of human cloning continues to be a significant national and international policy issue. Despite years of intense academic and public debate, there is little clarity as to the philosophical foundations for many of the emerging policy choices. The notion of "human dignity" is commonly used to justify cloning laws. The basis for this justification is that reproductive human cloning necessarily infringes notions of human dignity. DISCUSSION: The author critiques one of the most commonly used ethical justifications for cloning laws - the idea that reproductive cloning necessarily infringes notions of human dignity. He points out that there is, in fact, little consensus on point and that the counter arguments are rarely reflected in formal policy. Rarely do domestic or international instruments provide an operational definition of human dignity and there is rarely an explanation of how, exactly, dignity is infringed in the context reproductive cloning. SUMMARY: It is the author's position that the lack of thoughtful analysis of the role of human dignity hurts the broader public debate about reproductive cloning, trivializes the value of human dignity as a normative principle and makes it nearly impossible to critique the actual justifications behind many of the proposed policies.

Attitude↗
PubMedDate not supplied

Death data as input to policy-making.

United States and international mortality statistics are analyzed for various applications because of their importance for identifying and monitoring health problems, developing programs for disease prevention and health promotion, and for portraying trends and patterns. Since public and corporate policy is significantly affected by vital statistics data, the quality of the information on the death certificate should be as accurate and complete as possible.

Cause of Death↗
PubMed2006

Medical workforce policy-making in Canada, 1993-2003: reconnecting the disconnected.

The authors set out to review Canadian medical workforce policies for 1993 to 2003 and assess if data existed in the 1990s that could have reversed the policy decision to curtail the supply of physicians from Canada's medical schools just as Canada was about to experience a developing shortage. The authors reviewed existing descriptive data sources regarding Canadian physician workforce size and activity from 1986 to 2003, including the Canadian Medical Association workforce database. The review indicated that a significant loss of physicians to retirement was imminent. Physician workforce productivity had started to fall by the early 1990s. Emigration to the United States had risen above traditional levels in the early 1990s and remained higher into the late 1990s. Despite these existing findings, an integrated adjustment to physician workforce policies taken in 1993-94 only occurred after 1999. The authors recommend that policy makers and managers must monitor the numbers from existing sources. To optimize these sources, planned data tracking and linkages are essential. The period in question demonstrated major disconnects in coordinating implementation, wherein subject experts monitoring data trends were not adequately utilized by policy makers. Finally, in complex systems with regional differences, policy decisions based on normative data are insufficient.

Canada↗
PubMed2001

Science in regulatory policy making: case studies in the development of workplace smoking restrictions.

OBJECTIVE: To study the role of science related and other arguments in the development of workplace smoking regulations. DESIGN: Case study, content analysis SUBJECTS: Written commentaries and hearing transcripts on proposed indoor air regulations in Maryland and Washington. MAIN OUTCOME MEASURES: We coded each written commentary and hearing testimony for position toward the regulation, affiliation of the person submitting it, criteria used to evaluate science and scientific, ideological, economic, political, engineering and procedural arguments. RESULTS: In both states, opposition to the regulations came primarily from the tobacco industry, small businesses, and business organisations and appeared to be coordinated. There was little coordination of public health support for the regulations. Arguments about science were used more often by those opposed to the regulations than by those in favour. Supporters emphasised the quantity of the evidence, while opponents criticised its reliability, validity, and quality. Arguments not related to science (61% of total arguments; 459/751), were more common than scientific arguments (39% of total arguments; 292/751). Economic and ideological arguments were used to a similar extent by regulation supporters and opponents. CONCLUSIONS: Advocates can support health related regulations by submitting commentary emphasising the sound research base for regulation and countering criticisms of research. National coordination of these efforts could avoid duplication of effort and make more efficient use of limited public health resources.

Health Promotion↗
PubMed2001

Rationalising chances of success in intersectoral health policy making.

OBJECTIVE: It is generally accepted that a wide range of factors determine the health of a population, many of which are beyond the remit of the Ministry of Health. The aim of intersectoral health policy is to influence these factors. Success depends on a multi-stage process. This paper aims to provide support for the first stage of this process in the form of a quick scan for appraising the feasibility of intersectoral health policy. DESIGN: The content of the quick scan for intersectoral health policy was derived from a literature review. To determine the usefulness of this quick scan, the study looked at two examples in the policy sectors of education and safety. MAIN RESULTS: The quick scan distinguishes between three factors: (1) the availability of evidence, (2) the degree of support, and (3) the availability of tools for implementation. The quick scan made it possible to review the two policy sectors systematically in a relatively short time and to obtain sufficient information for priority setting in intersectoral health policy. The examples in this paper suggest that intersectoral health policy for community safety is more feasible than intersectoral policy for psychosocial problems in secondary education. However, specific information is required for a more precise assessment of feasibility. CONCLUSIONS: There are many ways of improving health through intersectoral health policy. The proposed quick scan may provide systematic support for setting priorities before developing policies of this kind.

Adolescent↗
PubMed1998

Senate voting and social construction of target populations: a study of AIDS policy making, 1987-1992.

Scholars have devoted considerable attention to analyzing the social construction of AIDS. To explore the politics of AIDS policymaking, this research uses Schneider and Ingram's (1993) theory of the social construction of target populations to evaluate the U.S. Senate's response to AIDS between 1987 and 1992. Our study found that Schneider and Ingram's model provides important insights into how political processes affect AIDS policy design. While our data did not strictly conform to all of the model's theoretical expectations, the data provided evidence confirming its predictions about broad patterns in the allocation of both substantive and symbolic policy benefits and burdens to different target populations.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Will using evidence-based approaches to a standards development process improve Medicaid policy making? Report on a promising effort.

In theory, evidence-based medical necessity policy in health care utilization review may make resource allocation more equitable. Costs can be managed through the consistent application of standards for approval of only those services deemed medically necessary and by controlling denials and appeals litigation. Additional cost savings may be realized with more efficient utilization review processes and concentration on review standards for the specific items or services that have the greatest financial impact on overall utilization dollars. This article describes a five-step process for evidence-based medical necessity standards development and includes illustrative examples from a state Medicaid agency project. While early results are promising, data are scarce. The authors, nevertheless, believe the approach may prove to be useful on promoting the application of evidence-based decision making.

Benchmarking↗
PubMed1991

Politics and equity in policy-making for the medically uninsured.

A sizable number of Americans (many of low income) lack health insurance, and their ranks grew over the 1980s. One might expect to find vigorous political efforts to redress this inequity. In fact, conflicting normative and practical images of equity have blunted the sense of urgency of the problem, inhibited agreement on the proper division of labor between the market and government, and blocked consensus on strategic models for public policy for the uninsured.

Health Policy↗
PubMed1994

Physician supply modelling in the United States of America and its uses in assisting policy making.

This article describes the major features and uses of the United States Public Health Services' Bureau of Health Professions' (BHPr) physician supply model. Within the space allowed, and referring the reader to the indicated references for further detail, a brief overview and history of the BHPr modelling program in general, and of the physician supply and requirements models in particular is provided. The physician supply model's major methodological features, data bases and recent policy applications are then elaborated. In this latter part, the reemerging importance of physician supply forecasting in the United States health care reform and policy debate is illuminated by examples from the recent journal literature and several major government and advisory council reports. Finally, some of the limitations and challenges for modelling physician supply in the 1990s are highlighted, as this nation likely faces the most fundamental restructuring of its health care system since the introduction of Medicare and Medicaid nearly 30 years ago.

Computer Simulation↗
PubMed1983

Private agencies for public purposes: some new perspectives on policy making in health insurance between the wars.

The approved societies, who were charged with the administration of health insurance in Britain, have long been blamed for the failure of the scheme to expand its coverage or scope in the interwar period. This paper takes a closer look at the administrative process and argues that societies were more vulnerable to central regulation than is commonly thought and were unable to resist cuts in public subsidies and extensions in liability introduced at their expense. They provided a convenient scapegoat for policies emanating primarily from the economic orthodoxy subscribed to by both government and the Treasury, modified to protect the unemployed during the slump. Health insurance policy was dominated to a large extent by the Government Actuary, who aimed to guarantee the cost effectiveness of the scheme. This paper also shows how administrative definitions and practices affected the classification of claimants to state social insurance at this time. It re-establishes the major weaknesses of the system, arguing that--in the light of recent discussions about reviving a system of national health insurance--we have much to learn from looking again at the experience of the interwar period.

Insurance, Health↗