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Selecting Evaluation Criteria and Evaluating Policy
FPMU120: Health Policy for healthy lifestyles Yuyan Shi, PHD Department of family medicine and public health University of California, San Diego Spring 2016
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Lecture Outline Announcements
Homework assignment #1 grades have been posted Homework assignment #2 due half hour ago Send group presentation materials and topic to TA Individual presentation on health policy topics This lecture: Learning objectives Policy evaluation Criteria for policy evaluation
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Previously in FPMU 120… Identified key provisions related to healthy lifestyles in: Medicaid Medicare 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) 2010 Patient Protection and Affordable Care Act (ACA) Described federal and state funded programs for healthy lifestyles Tobacco control Alcohol and drug abuse rehab Food program
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Learning Objectives Identify the types of policy evaluation
Identify the major policy evaluation criteria commonly used in health policy decision making Apply policy evaluation to a health policy problem
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Bardach Eightfold Path for Policy Content Analysis
1 Define the problem 2 Assemble evidence 3 Construct the alternatives 4 Select the criteria 5 Project the outcomes 6 Confront the trade-offs 7 Decide 8 Tell your story
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Public Policy Making Process
Policy Content Analysis
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*What is Policy Evaluation?
Policy evaluation: learning about the process and consequences of public policy Ex-ante evaluation: before the policy is chosen, designed, and implemented To inform policymakers of the possible consequences of various policy options before they are adopted Ex-post evaluation: after the policy is implemented Assess how a public policy has actually influenced the problem Process evaluation: during policy implementation Assess to what extent a policy is implemented and the conditions that promote successful implementation
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Who Evaluates the Policy?
By anyone who wish to influence the policymaking process Academic scholars Independent research institutes Consulting firms Government agencies Interest groups
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*Policy Evaluation Criteria
Goals/values Efficiency Equity/equality Security Liberty/freedom Practical considerations Effectiveness Political feasibility Social acceptability Administrative feasibility
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*Efficiency The achievement of policy goals or benefits in relationship to the costs We want the least cost for a given benefit or the largest benefit for a given cost Cost-effectiveness evaluation Cost-benefit evaluation
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*Equity and Equality Equality: equal distribution of the policy’s costs, benefits, and risks across population and subgroups Equity: fairness or justice in the policy process or distribution of the policy’s costs, benefits, and risks across population and subgroups Process equity Outcome equity
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Chocolate Cake Example
What is the most equitable way to distribute the cake to the class? Source: Stone, Deborah A. Policy paradox and political reason. Harper Collins, 1988.
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*Possible Solutions to the Cake Problem
Who Membership Rank-based distribution Group-based distribution What Need of the item Value of the item Process Competition Lottery Voting Source: Stone, Deborah A. Policy paradox and political reason. Harper Collins, 1988.
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*Security Being free from danger or threat
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*Liberty/freedom Extent to which pubic policy extends or restricts privacy and individual rights and choices
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*Effectiveness Likelihood of achieving policy goals and objectives or demonstrated achievement of them Non-experimental evaluation Randomized controlled trial Quasi-experimental evaluation
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*Feasibility Political feasibility Social acceptability
The extent to which elected officials accept and support a policy proposals Social acceptability The extent to which the public will accept and support a policy proposal Administrative feasibility The likelihood that a department or agency can implement the policy well
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Tradeoffs Between Goals
Equality/Efficiency Tradeoff Security/Efficiency Tradeoff Liberty/Security Tradeoff Liberty/Equality Tradeoff Liberty/Efficiency Tradeoff
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An Example: Motor Vehicle Deaths
Policy Options Air bags Safety belts Driver education Enhanced enforcement of existing drinking and driving laws Source: Shannon Frattaroli and JHU. How Did an Air Bag Get into My Steering Wheel? A Case Study in Injury Prevention Policy.
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Determine the Criteria
Reduce deaths Reduce severity of injuries Easy to use Ready to implement Universally applicable Affordable Easy to maintain Source: Shannon Frattaroli and JHU. How Did an Air Bag Get into My Steering Wheel? A Case Study in Injury Prevention Policy.
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Project the Outcomes and Confront the Tradeoffs
Source: Shannon Frattaroli and JHU. How Did an Air Bag Get into My Steering Wheel? A Case Study in Injury Prevention Policy.
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Project the Outcomes and Confront the Tradeoffs
Source: Shannon Frattaroli and JHU. How Did an Air Bag Get into My Steering Wheel? A Case Study in Injury Prevention Policy.
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This Lecture Identified the types of policy evaluation
Identified the major policy evaluation criteria commonly used in health policy decision making Applied policy evaluation to a health policy problem
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Next Class: Group Presentation
Assessment from the audience (your classmates, TA, and instructor) Are the problem and policy clearly presented and easy to understand? Did your presentation draw attention? Is the presentation persuasive and convincing? Is the policy appropriate and potentially effective to address this problem? Overall, would the audience support this policy?
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Lecture after Group Presentation
Policy Making Policy Strategies Policy Evaluation Mass media tools Policy making and content analysis Non-experimental and RCT Economic tools Quasi-experimental design Problem definition and agenda setting Legal tools Cost-effectiveness Regulatory tools Interest group Cost-benefit Healthcare financing Criteria selection
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