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The Public Policy Process Part II


A policy refers to a rule or a strategy that can be used as a guide to achieving a specified outcome (Birkland, 2010). Policies are usually made by institutions and governments to help in achieving predetermined objectives. The policies made by the government are often referred to as public policies and are used to help the government to solve a given public problem (Birkland, 2010). The government of America has always been faced with the challenge of providing affordable and high-quality health care to its citizens for many years. It is against this backdrop that the government adopted the Patient Protection and Affordable Care Act (PPC) as a policy that would help in addressing the health care problem (Goodson, 2010). The PPACC aims at improving efficiency within the health care system as well as lowering the cost of accessing medical services in the country (Goodson, 2010). The success of a policy must be verified through sound evaluation criteria in order to determine if the expected outcome was achieved or not. The outcome of the evaluation can lead to adoption, rejection, or redesigning the policy. This paper analyses the evaluation, analysis, and revision stages of making a policy in the context of the PPACC. The purpose and the methodology for analyzing and revising a policy will also be highlighted.

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The evaluation stage in policy making involves assessing the success of the policy (Birkland, 2010). This means that the evaluation stage has to be done after the implementation stage. The stage comes after the policy has been implemented over a period of time such as six months or a year. The evaluation is done by assessing the performance of the program that is guided by the policy (Birkland, 2010). For example, the PPACC will be evaluated by assessing the performance of the new health care system. The target or the expected outcome acts as the benchmark for evaluating the policy (Birkland, 2010). The PPACC for instance was meant to reduce the costs of accessing health care by providing universal insurance cover to the general public (Goodson, 2010). This will then translate to a systematic reduction in the country’s foreign deficit in the next ten years (Goodson, 2010). The overall aim of the policy is to improve the health and physical wellness of the country’s population. Thus the indicators that will be used as benchmarks for evaluating the policy include the level of foreign deficit, cost of accessing health care, frequency of illnesses, and availability of health care services.

The evaluation process is an all-inclusive exercise that must involve all stakeholders in the program that is supported by the policy (Wilson, 2005). This means that the processes can not entirely be the responsibility of policymakers. Thus the evaluation of the PPACC policy must include the public, government officials, private sector representatives, and external experts. The rationale behind involving all stakeholders is to obtain an unbiased position on the success of the policy. The success of the policy can be evaluated as follows. First, the feedback obtained from the beneficiaries of the program supported by the policy will provide the data for the actual evaluation (Wilson, 2005). This will include the citizens’ views on the benefits and costs of the new health care program. A positive response from the citizens is an indication that the expected outcomes are being achieved. The responses of the beneficiaries should be based on evidence rather than assumptions in order to enhance the integrity of the evaluation (Wilson, 2005). Second, the progress of the policy should be rated by peers (Wilson, 2005). This means that external experts from countries with a similar policy will also rate the performance of the policy. Their opinion represents the unbiased view on the policy. Third, evaluation can be done by observing the indicators of success (Birkland, 2010). For example, the reduction in illness cases, increase in demand for health care services and reduction in foreign deficit are all observations that can be used to evaluate the success of the PPACC policy. Finally, the evaluation will only be useful if the criteria used are reliable. Reliability can be enhanced by setting precise and relevant evaluation objectives coupled with the use of appropriate evaluation techniques (Birkland, 2010).

Analysis Stage

The analysis stage is mainly concerned with the effectiveness of the policy in achieving its purpose (Wilson, 2005). Thus it relates to the extent to which the objectives of the policy have been achieved. It involves an in-depth examination of the policy using the set objectives or expected outcomes as the benchmark for assessment (Birkland, 2010). Statistical tools such as percentages, means, ratios, and averages can be used to obtain greater insights into the success of the policy. In the context of the PPACC policy, the analysis will involve determining whether the health care program’s budget is within the $ 900 million limits that were authorized by President Obama (Goodson, 2010). The program aims at “providing cover to 94% of Americans” (Goodson, 2010). Thus it will be necessary to calculate the percentage of Americans that have been covered at the time of the analysis.

The analysis process involves asking a series of questions which include the following. First, the policy analyst must find out if the right problem was identified (Birkland, 2010). The physical wells of the population and the efficiency of the health care system will shed light on this question (Goodson, 2010). Second, it is necessary to find out if all the aspects of the problem were identified. The problems encountered during the implementation stage reveal the extent to which the aspects of the problem were identified (Wilson, 2005). For example, PPACC was focused on the interest of the public sector. However, the policy might not be effective if it overlooks the private sector’s concerns such as a reduction in demand for private health insurance (Goodson, 2010). Third, the analysis focuses on the degree to which the recommendations or strategies were implanted (Wilson, 2005). To answer this question, reference must be made to the PPACC proposal in order to find out what has been done and what has not been done. It also involves identifying what was not done correctly during the implantation stage. The analysis ends with a recommendation on whether the policy should be modified, abolished, or redesigned. If the policy analyst decides to modify the policy, his or her recommendation must include an explicit statement of what should be changed.

Revision Stage

At this stage, the limitations identified in the analysis stage are addressed (Birkland, 2010). The first step involves “defining the identified problem” (Birkland, 2010). This is followed by the identification of several alternative strategies for addressing the problem. For example, the PPACC policy overrides insurers’ rights to deny risky clients an opportunity to be covered and this increases the risk profile in the health insurance business (Goodson, 2010). To address this problem, the policy has to be modified to accommodate the concern of the insurers as it facilities the provision of insurance coverage to all citizens. A cost-benefit analysis will be used to assess the viability of the various alternative strategies (Birkland, 2010). Environmental impact assessments will be used to forecast the impacts of the identified strategies (Wilson, 2005). Finally, the strategy identified using this criterion is implemented as a modification to the policy. Compensating insurers for the risks associated with providing cover to risky clients is an example of a modification that can be considered in the context of PPACC policy.

Purpose and Methodology for Evaluating and Revising a Public Policy


Public policies are evaluated for three main reasons. First, the process encourages the economic use of scarce resources. Evaluation helps in identifying potential causes of failure while revision helps in addressing such causes of failure (Wilson, 2005). Second, the process of evaluation and revision helps policymakers to learn from the current lesson and use their experiences to plan effectively in the future. Finally, the process helps in improving the quality or benefits of the programs that are guided by a given policy. This is because the process allows emerging concerns to be incorporated into the policy or program.

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The process of evaluation and revision usually occurs concurrently. This is due to the fact that problems are usually addressed as soon as they are identified. Thus the process of evaluating and revising a public policy can be done as follows. First, the policy has to be evaluated before and after implementation (Birkland, 2010). In this case, the evaluation focuses on the contributions of the policy from the time of its implementation (Birkland, 2010). This involves comparing and contrasting the situation before and after the implantation of the policy. There should be control on the effects of variables that can influence the expected results. For example, an increase in purchasing power might cause a corresponding increase in demand for health care. Thus while assessing the contribution of the PPACC policy in enhancing access to health care; economic variables such as a potential increase in purchasing power must be controlled. The second stage of evaluation involves assessing the effects of the policy in the target group (Wilson, 2005). This is done by examining, comparing, and contrasting the situation between the population in which the policy has been implemented and a population without a similar policy. The third stage involves examining the effectiveness of the policy in achieving its purpose. In this case, the analysis is done after the implantation, and “the situation is not controlled to exclude the possible influence on the results” (Wilson, 2005). Finally, the effects of the policy must be traced for a long period of time. This entails a time series analysis of the contributions of the policy in the long term.


Public policies help governments to address specific issues such as the health care problem in the USA. An effective policy-making process must include sound evaluation criteria (Birkland, 2010). The evaluation process helps in tracking the success of the policy over time (Birkland, 2010). The analysis stage helps in determining the effectiveness of the policy in achieving the set objectives. The limitations identified at the analysis stage are addressed by adopting the appropriate mitigation plan during the revision stage. The main purpose of evaluating and revising a public policy is to avoid failure through early detection and correction of emerging undesired situations.


Birkland, T. (2010). An introduction to the policy process: theory, concepts and models. New York: M.E Sharpe.

Goodson, J. (2010). Patient protection and affordable care act: promise and peril for primary care. Annals of Internal Medicine, vol.152 (11) , 742-744.

Wilson, C. (2005). Public policy: continuity and change. New York: McGraw-Hill.

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