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The Eightfold Path

Introduction to policy analysis using the eightfold path by Eugene Bardach

Roberta Lavin

on 3 December 2014

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Transcript of The Eightfold Path

Health Policy
Understanding policy analysis: The Eightfold Path
Define the problem
Assemble some evidence
Construct the alternatives
Select the criteria
Project the outcomes
Confront the trade-offs
Tell the story
The Eightfold Path
Using values, evidence, and process to make wise political & social decisions
This is the reason for doing the work
Defining the Problem
"What private troubles warrant definition as public problems and thereby legitimately raise claims for amelioration by public resources?"
In brief - Market Failure
Non-market failures such as family breakdown, low living standards where markets don't reward lack of skills, and discrimination
The Affordable Care Act
Let's Take an Example with Lots of Issue Rhetoric
There are
many uninsured
There are
many abortions
There are
many unwanted pregnancies
Contraception is
expensive for some
Are any of these the problem?
Why are there
many teenage pregnancies?
How much is too much?
What is the magnitude of the problem?
Rather than Rhetoric try Quantifying
How much should women pay for contraception?
How much should insurance cover?
How many abortions are too many?
How many could be prevented by contraception?
You must gather information about the
of the problem
You may need an estimate or set a range and make sure you aren't using this to define the solution
Assemble the Evidence
Don't define the solution into the problem
You should not say - There are too few contraceptives available to teenagers.
This assumes making contraceptives available would stop teenage pregnancy.
Collect only that data that can be turned into information and then converted to evidence
data are facts
evidence is information that affects the beliefs of people about significant features of the problem
Data and Evidence
3 Purposes for Evidence
Assess the nature and extent of the problem
Assess the particular features of the concrete policy you are studying
Assess policies that have been thought to work and have been effective in similar situations
Policy options
Construct Alternatives
Not all options are mutually exclusive
Start with more options, but when it is time to present keep it to two or three
Don't ignore current political sentiment
Bardach suggest making one alternative basically the
status quo
I strongly disagree with this approach if you think that is unacceptable
The problem with much government policy is that too many people accept the
status quo
and say it is acceptable to do nothing when if fact it is not
Policy analysis is not for the weak of heart!
Bardach suggest consulting or getting input from outside sources - to what extend this can be done depends on who you work for and what the law allows without public notice
Don't forget the trade offs - resources and SOPs
Can we do it and should we do it?
Select the Criteria
Don't spit in the wind criteria
Criteria that you can't ignore
You selected the options - project the outcomes from each
Project the Outcomes
Be realistic
Use social science
Use multiple models and look for the best model
Watch out for undesirable side effects (moral hazards, overregulation, cost of being wrong)
Don't forget that you still need evidence
What is minimally acceptable effectiveness given costs?
What new processes or change could achieve the desired effect?
How likely is it to be implemented and that it will achieve the desired outcomes?
Don't forget to consider the possibility of failure!
Four Steps in Confronting the Trade-offs
How can a Congressperson vote for that?
Confront the Trade-offs
Sometimes a decision must be made between cost of a service for some people versus the total cost per year
First convince yourself
The twenty dollar bill test
Just because the answer seems good and obvious the fact that no one has done it doesn't mean it is really a bad idea.
Good ideas (good options) require effort and follow through
Just like bench research. It is wonderful, but if no one figures out how to get it to the beside what happens? It requires follow through.
Tell Your Story
The criteria established are meant to judge the outcomes and not necessarily the alternatives themselves
What are some common criteria
Efficiency: cost-effectiveness
Equality, equity, fairness, and justice: does social justice matter
Freedom, community, and other ideas: freedom for unreasonable intrusion or manipulation and equity in the community
Process values: democracy and the belief that people should have a say about what affects them
Telling your story is about knowing the audience and appealing to the audience
Legality: don't waste time with policy that violates the Constitution or the law
Political Acceptability: if it isn't politically acceptable it is not going to happen
Real World: Sounding good on paper isn't enough
Full transcript