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Health policy is the action, plan and decisions taken to attain specific health care goals within the society. As the technology is advancing, the priorities of the people have been changed. Along with this the people are aware of the health issues and they want to reduce the level of diseases, premature death and want to secure themselves and their families from disease produces discomfort. To overcome this fear of the person, Public Health infrastructure is created and it refers to the legislative, informational and administrative system for developing health policies. (World health organisation)
Australian Government has a big financial role and broad policy leadership structure in health matters. The State Legislatives fulfil their role in delivering public sector health services and coordinates with the working of health workers in public and private sectors. The Government facilitate in planning and developing the national public health policies by identifying and researching on public health issues. In every country the process of developing health policies depend on how the government takes care and solves the problem in the society. Government institutions form the alternatives to the issues and select the solutions which are evaluated, implemented and revised if required.
For this the main agenda for the health policy is planned after the minute research about the health status of the country. The agenda setting is the process of highlighting and seeking the attention of the Government towards the problem so that the solution can be considered. It is the result of the policy process involving executive branch leaders, legislators, influential stakeholders and public. (National Public Health Partnership)
Though people of Australia have a fantastic overall health record, but the people want a public health policy related to free health care in Australia. There was a policy analysis resulted with the current health issue in the health sector of Australia, which is becoming a major health issue in the future times. The policy instruments related to the particular set of problems are analysed. The policy instruments are the tools like taxes, spending, incentives and legal and voluntary regulations used by Government. (Cairney, 2013)
While designing the free health care policy for the public, there are certain points which should be discussed in the agenda. The issue should be important enough to be consulted in the legislations.
Subsequent and emergency movements are used for initiating the policy making process. Number of problems are listed and merit that considers the problem. For planning on the health policy there are myriad of problems and issues that demand attention. If the issue is quite surrounded by the noise of the public, the issue becomes important and gets its way onto the agenda. As the agenda for the issue for free health policy for Australians is introduced and discussed it is not a hundred per cent surety that it will be accepted as the formation of the legislation. Not all the agendas that get into policy process form the end up forming the law as the formation of legislation is a complex process. It is because of the lack of time, information, resources and many more other things. Certain issues should be strategically planned to put in the agenda. (Boundless)
There are theoretical approaches that explain the health policy agenda settings.
The kingdom model: The Kingdom model refers the process of agenda setting in which, problems, their solutions and political circumstances are coming together. This model is based on the fact that the only problems cannot justify legislations, there are reasonable solutions to it. The kingdom model was introduces in 1965 and it explains the issues like how to highlight the problems in the agenda and how the alternative solutions to the problems are devised. It tells about the three streams, they are problems, policy and politics and the window of opportunity. The kingdom model considers them as the four important concepts.
Problem stream considers that all the problems cannot be considered while creating a policy. So the problems have to be urgent or important. While developing the free health policy the first problem is felt by the legislators that the individual will need to get locked to the job because he does not want to lose the policy. The other problem is the individual’s location. People travel to different places to attain the best opportunity and the free health care and have to find the free clinics in the panels. The access is the other problem related with the free health care as this facility rely on the external funding and there could be a long waiting period to avail it. After attaining the policy, people will face a problem to get the appointments as there too will be long waiting period. The burden on all the parties is increased as the policy holders are more than the suppliers. In the free medical care sector, the quality of the medical care is another problem. It’s not due to the working efficiency of the workers related to the free health care sector, but because of the lack of the latest equipments at the free health care centres. The good doctors and nurses can also not do their job well when there is the lack of the medical facilities. As the waiting period to avail the free health care is so long, the follow up to the problem of the patient is the another issue. When the problem affects a large number of people, they take their steps towards the agenda. The major role of Advanced practice nurses are that they utilise the full opportunity to bring the issue of free health care policy for Australians on the agenda. (Roberts, n.d)
Every problem has a solution. The policy actors work on it and create policies which are considered as the solutions to the relative problems. This reduces the speed of the policy making procedure as all the possible solutions to all the problems are considered. The health care researchers do complete justice in analysing the developing the alternative solutions to all the problems related to free health care for Australians. This research influences the process of policy making decisions. The Governmental research and implementation of the policy making decisions are different from the private sectors as this have different consequences being related to the large number of people. So the Rational decision making process first defines the problem, develops an alternative solution, evaluate the solution and plan to implement and add it in the agenda. The relevant solutions to the problems related to the free health care for Australians can be to create a single payer system, negotiating the lower prices for drugs, one universal set of insurance policies, procedures and uniform set of regulations. This could save a large amount of money and that could be utilised in the free health care projects. (Public Agenda)
According to the Kingdom Model, the third stream is the political circumstances. The most complex procedure in the window opportunity is the political circumstances related to each problem and their potential alternative solutions and to make the policy maker to take actions. The agenda should be appropriate otherwise one policy and the support it is overshadowed by some other policies and their support. The factors that affect the political circumstances are the concern, public attitude and opinions about the issues of the policymakers in the legislative and executive branches of Government.
When the Country is involved in some risk or threatened like the threat to the security, civil wars, recession, the health policy is treated in a different manner. This also depends on the factors that influence the importance and the economic conditions of the country.
The other theoretical approach to explain Health policy agenda setting is the Hall’s model.
Hall’s model: Hall proposed that if the issues have to seek Government’s attention. For this proper promotion of the issue is required. This means the Government should feel that the requirement of the policy is very high in the real world. The Government should feel the efficiency of the policy in relation to the cost. So basically Hall model suggests that when an issue becomes very responsive in terms of their feasibility, legitimacy and support, they get the place in the Government agenda.
Legitimacy: It is a characteristic of issues because of which the Government understands and believe that they should be concerned to the issues and to feel a right to intervene. Every citizen of the country expects from the Government to work for their betterment and keep the law and order and to defend the country and its citizen’s from any kind of attack and risks.
Feasibility: It is related to the potential of the Government to implement the policy. It needs the existence of the resources, skilled staff, technical and theoretical knowledge, necessary infrastructure and capable administration. If there is a lack of financial, workforce and technology, the policy may not be implemented. It doesn’t matter that how high the legitimacy is, the calibre in the Government is required.
Support: It is related to the public support to the Government regarding the implementation of the policy. The media also plays an important role in creating awareness among the people and letting them know that what is there in the agenda to be discussed. In the implementation process of health policies, the government expect the support of the community and health care sector. If the Government is lacking in getting the support, it will be difficult to put the issue in the agenda. (Kazmi, n.d)
Losing agenda settings: Sometimes due to change in the conditions like political issues, change of Government or decision maker removes the attention of the Government from the agenda. This leads to the losing of agenda settings.
Sometimes the problems highlighted in the agenda get vanished and changes the agenda settings. This also results in the losing of agenda.
Sometimes people get accustomed with the problem, and they do not feel it as problem anymore. Agenda settings are also loosed in such situations. (Anggoro, 2012)
How a Bill becomes a law: As discussed earlier that only a few of the proposed legislation actually succeed to become a law. If any agenda dies in the middle of the session, it has to be resubmitted and reintroduced in the new session to become a law. The bill may die because of the disagreement between the members and amendments in the original bill.
Bill origination: The members of the house representatives present the bills with specific agendas. Most of the bills are presented by the legislators. There ideas come from the supporters, president and the interest groups. They have executive communication between them. Proposal does not matter, in the end the member of the house introduces the legislation.
Drafting the legislation: The staff members of the bill’s sponsor draft the legislation. Ultimately they are responsible for the language written and used in the legislation.
Introduction of the Legislation: The bill is then presented in both the houses and a debate and discussion on it done. If maximum number of the members speak in favour and are keen to implement the policy in the country, they send this bill in the standing committee which has jurisdiction for the bills.
Legislative committees with health policy jurisdiction: Majority of the health bills are referred to the senate committee on labour and human resources and the house committee on commerce.
Report comes out of committee: A hearing is conducted in the committee. The whole bill is evaluated line by line and the amendments are done if required. Similar bills are combined at the same time. If the bill comes of the committee, a member makes a report on it mentioning the final points to be finalised and the reasons that why the committee is in its favour. Any bill that does not succeed to come out of the committee is considered as a die bill and is reintroduced in the next session with improvements.
Action: Considering the amendments on the bill and the final report of the committee, once again a debate takes place in both the houses. If the amended bill is passed to the houses, it is further sent to another chamber where the referrals again consider this bill for evaluation. When the bill is passed through the chamber, it is sent to the conference committee for action.
Conference Committee actions: The bill is finally evaluated and analysed in the conference committee. A final report is drafted in support of the bill and is sent to all the houses and chambers for voting. If there is a majority of agreement from houses and chambers, the bill is finalised and is sent to the president for action. If there is disagreement at any step, the bill dies.
Presidential action: If the president signs the bill, it can become the law immediately. He can even reject the bill by veto. The bill becomes law within ten days of the signatures of the president. (Creating an agenda and developing legislation)
The health policies play a vital role in a human’s life to live without stress. People expect to utilise their tax for the reasonable purpose and availing health policies are one of them. The Australian citizens expect a free health care from the Government and for this purpose the policy agenda has to be drafted and should be successful in becoming a law. The above discussion lets an individual know about the steps required to design and develop a policy. Many people associated with many departments and sectors come together and work efficiently to frame it. The teams are conducted to research about the important agendas having issues and relative solutions. The collective hard work and support makes a normal bill to become an important law. (Furlong, n.d)
Creating an agenda and developing legislation, Retrieved from https://faculty.unlv.edu/ccochran/HCA452_652/Agenda_and_legislation.html
Boundless, Issue Identification and Agenda Building, Retrieved from https://www.boundless.com/political-science/domestic-policy/policy-making-process/issue-identification-and-agenda-building/
Furlong, E. Agenda Settings, Retrieved from http://samples.jbpub.com/9781449665098/97768_CH02_Milstead.pdf
Roberts, J., E How: Problems with Free Health Care, Retrieved from http://www.ehow.com/about_4777901_problems-free-health-care.html
National public Health Partnership, Public Health, Retrieved from http://www.nphp.gov.au/publications/broch/defin.htm
Kazmi, N., Scribd: Role of State in Health Policy, Retrieved from http://www.scribd.com/doc/15107462/Role-of-State-in-Health-Policy
Cairney, P., (2013), Policy and Policymaking in UK, Retrieved from http://paulcairney.files.wordpress.com/2013/08/chapter-2-20-8-13-cairney-policy-policymaking-uk.pdf
Public Agenda, Citizen’s Solution Guide 2012, Retrieved from http://www.publicagenda.org/pages/csg-health-care
World Health Organisation, Health Policy, Retrieved from http://www.who.int/topics/health_policy/en/
Anggoro, Y., (2012), The Use of Multiple Streams Framework in Agenda Settings, Retrieved from http://yudoanggoro.com/tag/agenda-setting/
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