When Health Policy Is the Problem: A Report from the Field
Abstract
We often think of health policy and health services research as offering solutions to cost, quality, and access problems. Many of us see health policy as simply ineffective. But any activity that has the power to cure can also do harm. Is it possible that the health policy enterprise has contributed to the very problems it has been attempting to eliminate? We argue that it has. Reasonable assumptions have led to a series of solutions that have provided political cover for those vested in the status quo. This process is nonpartisan, with those of us on the left and the right unintentionally and inadvertently contributing to the problems we are so committed to solving.
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Health policy outcomes may actually be, to a varying extent, subjectively derived despite the positive intent of EBDM.
“Therefore, despite the positive intent of EBDM, health policy outcomes may actually be, to a varying extent, subjectively derived [22,23,33,40,45,61].”
From Rationality versus reality: the challenges of evidence-based decision making for health policy makers (2010) · cites this paper as [61]
Despite the expectation of rationality in policy decision making, policy makers' decisions can include individual and group utility factors and be a source of bias because decision information is rooted in individual cognitive processing.
“Therefore, despite the expectation of rationality in policy decision making, policy makers' decisions can include individual and group utility factors and be a source of bias because decision information is rooted in individual cognitive processing [44-50,61].”
From Rationality versus reality: the challenges of evidence-based decision making for health policy makers (2010) · cites this paper as [61]
Cites
(2000) · doi:10.1017/cbo9780511803475 · Cited by 2,987 · see citing works
Uneasy alliance—clinical investigators and the pharmaceutical industry
Bodenheimer, T. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005183422024 · Cited by 765 · see citing works
Als-Nielsen, B., Chen, W., Gluud, C., & Kjaergard, L. L. (2003) · JAMA · doi:10.1001/jama.290.7.921 · Cited by 746 · see citing works
Khan, A., Leventhal, R. M., Khan, S. R., & Brown, W. A. (2002) · Journal of Clinical Psychopharmacology · doi:10.1097/00004714-200202000-00007 · Cited by 456 · see citing works
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McCaughey, D., & Bruning, N. S. (2010) · Implementation Science · doi:10.1186/1748-5908-5-39 · Cited by 160 · see citing works
- Authors
- Spitz, B., & Abramson, J.
- Affiliations
- Harvard University (US)
- Venue
- Journal of Health Politics, Policy and Law
- Publisher
- Duke University Press
- Published
- 2005-06-01
- Volume
- 30
- Issue
- 3
- Pages
- 327-366
- ISSN
- 0361-6878 (ISSN-L)
- 1527-1927
- OpenAlex
- W2019149161
- Cited by
- 30
- References
- 4
- Citations by year
- 2020: 1 · 2012: 2
- FWCI
- 18.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Health Politics Policy and Law (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Health Sciences › Health Professions › General Health Professions › Health, Medicine and Society
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
- Keywords
- health policy, unintended consequences, health services research, status quo, health care costs, quality of care, health care access
- MeSH terms
- Certificate of Need, Drug Industry, Health Expenditures, Health Policy, Health Services Research, Life Expectancy, Policy Making, Politics, United States
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