64). Again, this has been recently evidenced by the recent battles in Congress over the federal budget. Although the budget deficit did not directly involve health care policy, the result was a compromise on the budget that required a corresponding change in the health care policy as to Medicare. This is not an unusual situation in the area of health care policy. Often, budgetary concerns must be addressed which in long-term have an impact on the formation of health care policy.
The formation of health care policy does not occur in a vacuum and there is a constant struggle between interests. Too often the concerns of the majority are afforded too much consideration and the interests of smaller and seemingly less important segments of society are overlooked. This is a serious problem for policy makers and one that reoccurs frequently but a problem that is inherent to the process that policy is developed in a democratic society (p.68).
4) Discuss the concept of incrementalism in public policymaking.
One of the phenomena of policy making is the concept of incrementalism. In some isolated situations, public policies might undergo wholesale changes but in most cases public policy changes in stages which is described as incrementalism (p.150). The enactment of the Medicare program and the recent enactment of the Affordable Care Act are both examples of wholesale change but such enactments are the exception. The general governmental approach to policy change is to do so by building upon existing programs and modify them in response to what are seen as current needs. Wholesale changes are viewed as being disruptive and tending to upset the equilibrium that governments tend to prefer.
The process of incrementalism is believed to more predictable and the result is greater stability. It is only in the direst of circumstances that wholesale changes are considered; when an immediate or radical change is viewed as necessary....
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097 United States 0.109 0.093808 0.036112 0.068 Utah 0.1071 0.1401 0.035696 0.073 Vermont 0.1326 0.0988 0.040851 0.114 Virgin Islands NA NA NA Virginia 0.1048 0.0829 0.080009 0.092 Washington 0.1229 0.0669 0.027831 0.068 West Virginia 0.1293 0.0774 0.036499 0.055 Wisconsin 0.0954 0.0357 0.032367 0.097 Wyoming 0.1251 0.1453 0.053867 0.075 Notes All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories. Definitions Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period
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