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Two major questions to which public policy analysis has been addressed concern the relative influence of economic and political factors upon governmental policy, and the degree of linkage between government spending and the policy outcomes produced by these outlays. These questions are examined with data on health care policy in Yugoslav local governments (communes). A causal model is constructed to estimate the relationships among five conceptual stages in the policy process: (1) socioeconomic context (regional culture and economic structure), (2) political context (liberalism and bureaucratism), (3) government spending level (health spending per capita), (4) policy outputs (hospital beds and doctors per capita), and (5) policy outcomes (percentage of births and deaths with medical attention, and infant mortality rate). The causal model shows that political determinants of policy are much more important than economic ones among Yugoslav communes. Bureaucratization and political liberalism are clearly much more important than development context in determining spending levels; and bureaucratization has by far the greatest impact on health outputs. Popular political culture, rather than economic context, furthermore, emerges as the predominant influence on health outcomes. These causal patterns also indicate the existence of substantial discontinuities among the three stages of the policy process because health spending has only a marginal influence on outputs and because outputs and outcomes are only slightly related at best. What Sharkansky calls the previous investment necessary to create bureaucratic complexes explains the first discontinuity, whereas the second results from different cultural mores about 'health behavior' and about interactions with governmental authorities and with the modern world in general.

Cover -- Title -- Copyright -- Contents -- List of Illustrations -- Acknowledgements -- Introduction -- 1 Knowledge and Policy in the Literature -- 2 Knowledge Sources -- 3 Learning through Interaction -- 4 Analytical Practices -- 5 Articulating People, Ideas and Instruments -- 6 Forms of Knowledge and Knowing in Policy Work -- Appendix 1: The UK Department of Health, 2009-11 -- Appendix 2: Studying Practices in Practice -- Notes -- References -- Index

Political philosophy and policy making theory -- How we got here : U.S. health policy history -- Comparative national health systems and U.S. health policy -- Policy making theories -- From theories to application : policy choice and analysis -- Policy formulation and economic scoring -- Policy implementation -- Policy monitoring & modification -- Healthcare payment, cost drives, and economics -- Access, the uninsured, and health policy -- Policy and quality -- How to influence the policy process -- Applied theory for professional advocates.

Many papers included in this volume express skepticism regarding both the diagnosis of the American health system as fundamentally ailing and the prescription of greater public intervention in the financing and delivery of medical services as the remedy and sure path to recovery

Intro -- STRATEGIC IMPLICATIONS FOR GLOBAL HEALTH -- STRATEGIC IMPLICATIONS FOR GLOBAL HEALTH -- CONTENTS -- PREFACE -- Chapter 1 CENTERS FOR DISEASE CONTROL AND PREVENTION GLOBAL HEALTH PROGRAMS: FY2004-FY2009 -- SUMMARY -- INTRODUCTION -- CDC'S GLOBAL HEALTH PROGRAMS -- CDC Global Health Funding: FY2004-FY2009 -- Apportionment of CDC Global Health Funding: FY2004-FY2009 -- Global HIV/AIDS -- President's Emergency Plan for AIDS Relief (PEPFAR) -- Global Malaria -- President's Malaria Initiative -- Global Tuberculosis -- Global Disease Detection -- Pandemic and Avian Influenza -- Global Immunization -- Polio -- Measles -- Other CDC Global Health Programs -- ISSUES FOR CONGRESS -- Global Health Budget -- Global Disease Detection -- Staff Shortages -- Coordination of Global Health Programs -- Author Contact Information -- End Notes -- Chapter 2 GLOBAL HEALTH: APPROPRIATIONS TO USAID PROGRAMS FROM FY2001 THROUGH FY2009 -- SUMMARY -- INTRODUCTION -- USAID GLOBAL HEALTH PROGRAMS: FY2001-FY2003 -- USAID GLOBAL HEALTH PROGRAMS: FY2004-FY2008 -- CHANGES IN USAID GLOBAL HEALTH APPROPRIATIONS SINCE PEPFAR AUTHORIZATION -- FY2009 Appropriations -- Author Contact Information -- End Notes -- Chapter 3 THE IMPACT OF FOOD INSECURITY AND HUNGER ON GLOBAL HEALTH: ISSUES FOR CONGRESS -- SUMMARY -- INTRODUCTION -- BACKGROUND ON GLOBAL HUNGER AND FOOD INSECURITY -- DIRECT HEALTH-RELATED CONSEQUENCES OF HIGH FOOD PRICES AND FOOD INSECURITY -- Increased Hunger Related Deaths and Susceptibility to Disease -- INDIRECT CONSEQUENCES OF HIGH FOOD PRICES AND FOOD INSECURITY -- Deeper Poverty -- Declines in Agricultural Productivity -- Increases in Rural-to-Urban Migration -- Declines in School Attendance -- Declines in Future Learning and Earning Capacity -- Increases in High-Risk Activity and Vulnerability to HIV/AIDS -- U.S. RESPONSES TO THE GLOBAL FOOD CRISIS

Making effective health policy requires expert knowledge of an ever-changing technological, epidemiological, social, and economic context. One important vehicle for integrating expert research into the policy process is through linkages and exchanges between researchers and government officials. Many governments respond to this need for expert knowledge by using advisory boards that include academics. Many also integrate academic health policy researchers more fully into policymaking by making them short-term or long-term employees. Each of us (Sherry Glied, Raphael Wittenberg and Avi Israeli) has spent some time as an academic and as a regular member of a governmental policy-making body, in the US, England, and Israel, respectively. In this paper, we reflect on the lessons learned from our dual perspectives.