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Facilitating Change in Health Policy . By Mary Knutson, RN, MSN Health Vista, Inc. June 26, 2005. Introduction. Legislative change is generally slow and frustrating Health professionals and the public have more power to affect change than they realize

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Facilitating Change in Health Policy

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Facilitating change in health policy l.jpg

Facilitating Change in Health Policy

By Mary Knutson, RN, MSN

Health Vista, Inc.

June 26, 2005

Introduction l.jpg


  • Legislative change is generally slow and frustrating

  • Health professionals and the public have more power to affect change than they realize

  • Take initiative to communicate with your legislators

  • Try quick e-mail, phone calls, or letters

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Writing Letters to the Editor

  • Correct, inform, or enlighten readers

  • Make letters short and to the point

  • Make only one point per letter

  • Include name, address and phone number

  • Include your credentials

  • Use direct but respectful tone, not personal attacks

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Effective Personal Efforts

  • Use your unique experiences to illustrate your point

  • Be up-to-date on current events and legislative progress

  • Learn more about government systems and how health care is affected

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Quick Review:

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Stage 1: Policy Agenda

How do you get the government to consider action on a problem?

  • Define the problems that need or receive serious attention of public officials

  • Find out which groups and communities are concerned about that issue

  • Build coalitions

  • Use media to illuminate the problem

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Stage 2: Policy Formation

What do you think should be done about the problem?

  • Develop some acceptable courses of action

  • Utilize knowledge from others in the coalition

  • Communicate with a legislator for input

  • Ask about the expected barriers

  • Revise the proposed action if needed

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Stage 3: Policy Adoption

How do you get the government to accept a particular solution?

  • Develop support for a specific proposal among coalition and public

  • Communicate problem and proposed solution to legislators

  • Put a “human face” on the issue

  • Find legislative sponsors and co-sponsors Involve lobbyists, if available

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Stage 4: Policy Implementation

Understanding the legislative process

  • Government’s administrative “machinery” is applied to problem

  • Some ideas result in drafting of bill

  • Hearings

  • Committee Mark-up

  • Floor Action

  • Conference

  • Implementation

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Stage 5: Policy Evaluation

Did the policy work?

  • Efforts are made by the government to determine if the policy was effective or not

  • Policy research is focused on analysis of problem addressed

  • Cost-benefit analysis of impact of policy

  • Policy design may be studied

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What Matters to Lawmakers?

  • Votes

  • Politics

  • Public Opinion

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Legislators Have:

  • More issues than time

  • Thousands to millions of constituents

  • Their own interests, history, priorities

Be persuasive

Be persistant

Be clear and concise

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How to Develop Relationships

  • Communicate with legislators and staff

  • Find common ground

  • Always be honest and courteous

  • Know the facts and be a resource

  • Make it easy- Explain pros and cons

  • Know the “enemy” so you can prepare the legislator for the “attack”

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Finding Legislative Information

  • Bills in U.S. Congress: thomas.loc.gov

    Congressional Record, past and present

  • Regulations: nara.gov/fedreg

    Agencies, White House, Public Laws

  • Bills in State Congress:

    Search under (your state) legislative bills or search (your state) legislators

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  • Becoming involved in government is easier than you thought

  • Get to know legislators

  • Let them know what you think

  • Develop ideas and solutions for problems

  • You can make a difference!

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  • Information for this presentation was obtained from George Mason University’s Washington Health Policy Institute Course, June 6-10, 2005, Washington, D.C.

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