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Policy Initiation and Policy Modification

Both policy initiation and modification serve a similar purpose – they are aimed at addressing health concerns that can be solved by implementing public policy. There are, however, significant differences between the two policymaking strategies. The former one is the development of an original law that passes through all phases of policymaking, starting with the formulation phase and ending with public enactment (Barr, 2016). In other words, policy initiation is when a law is created without taking another legislation as a foundation (Blank et al., 2017). New policies may be required when previously unaddressed issues emerge along with unique contexts.

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In contrast, policy modification is a response to feedback loop inputs. After a law is enacted, it continuously listens for new proposals that may address concerns that were not considered in the original version of the law. When such feedback is accepted, the policy returns to the agenda-setting and development phase (Colebatch, 2018). The primary difference from policy initiation is that policy modification does not intend to devise an original law but rather alter the current version to meet new requirements (Birkland, 2019). In the contemporary public health landscape, most policies are modified instead of being developed from scratch.

Public policies that affect large populations are rarely developed and enacted as one extensive legislation. Instead, small measures are implemented, each of which introduces changes to previous law (Teitelbaum & Wilensky, 2017). By taking an incremental approach, it is much easier to construct a public policy that addresses a complex concern (Parekh, 2019). The need for incrementalism emerged from the lack of a knowledge base large enough to sustain comprehensive policies and development complexity. It is much easier to make ten small steps than making a single step that covers the same area.


Barr, D. A. (2016). Introduction to US health policy: The organization, financing, and delivery of health care in America (4th ed.). JHU Press.

Birkland, T. A. (2019). An introduction to the policy process: Theories, concepts, and models of public policy making (5th ed.). Routledge.

Blank, R., Burau, V., & Kuhlmann, E. (2017). Comparative health policy. Macmillan International Higher Education.

Colebatch, H. K. (Ed.). (2018). Handbook on policy, process and governing. Edward Elgar Publishing.

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Parekh, A. K. (2019). Prevention first: Policymaking for a healthier America. JHU Press.

Teitelbaum, J. B., & Wilensky, S. E. (2017). Essentials of health policy and law (3rd ed.). Jones & Bartlett Learning.

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