Wednesday, January 29, 2020

The political decision-making process Essay Example for Free

The political decision-making process Essay The political decision-making process BY Mrcheeks707 The political decision-making process is so irrational that a completely rational approach to health policy-making can hardly be achieved. Support, debunk or provide alternative paradigms or approaches to this statement, focusing on the development of a particular policy area you are familiar with, and using analytic tools and frameworks in health policy analysis. This paper will begin by briefly examining the role of the state in health and how the state or political system is structured to meet this obligation. It will then describe the types of policy, the stages of policy aking, and the uniqueness of health policy making. Having provided a solid foundation for understanding the political and policy making system, in the context of the Trinidad and Tobago scenario, it will delve into analyzing the policy making process, and directly answer the central question of the rationality of policy making in an irrational framework of government structure. Weather policy is taught of as an intent, strategy, hypothesis, objective, goal, principle, or a learning process, it should include what governments say they will do, what they actually do and what they ecide not to do (Walt, 1994). Buse, Mays Walt, (2005 cited in Gilson L, ed. 2012, p. 28) went on to say that health policy also includes decisions made by the private sector and other actions taken outside of the health system, which can have influence on diverse aspects of citizens health. Lipksy (1980 cited in Gilson L, ed. 2012, p. 8) also argue that Health public policy, the term used to differentiate from the broader public policy, is essentially the routinely daily practices of policy actors and their decisions that have been translated from the formal documents, which may ometimes be far removed from the original intent. Regardless of whether the broader objectives focused on in macro/systemic polices of high politics or the finer special interests objectives being met in mic ro- sectoral polices of low politics, there is a general public policy process that should be followed (Evans and Newnham, 1992). To fully appreciate the impetus for health policy making in the public sector, one must understand the role of the state in formulating polices. As most develop and developing countries had been steered to accept the Keynsian philosophy, that f assuming the dominant responsibility in the provision of health services to the public amongst other social services (Walt, 1994), by the 1980s most states were beginning to relinquish its role in the direct provision of services. Despite governments continued attempts to divest the provision of health services to the private sector, urged in part by the World Bank, International Monetary Fund (IMF) and the diminishing resources of individual states, the critical health concerns of a nation will always mandate that some aspects of health care are treated at a central level. The complexities of health professionals training, controlling the spread of HIV and AIDS, and immunization of children, are too critical for a state to leave totally in the hands of private interest. So who or what is this state that has been entrusted with this responsibility of developing public policy, which ultimately impinges on every facet of citizens lives. This state, a subset of the wider political system, is composed of all the authoritative decision-making bodies of the society that maintains law and order while extracting and utilizing revenue, to provide services ncluding health ). Thus, based on the scarcity ot state resources, governments have no choice but to ration goods and services, even values, to varying and competing interest groups. This however, highlights the major flaw of the system model, in that it adopts the position that the state is impartial, and will distribute resources according to need rather than to the clout of interest groups. For one to fully understand the processes of policy making, one must examine it through the lens of policy theories. As macro theories place heavy emphasis on power in political ystems, which its effects are more systemic in nature than micro theories. While the more obvious internal political structure of a nation can facilitate or hinder participation in the policy making process, exogenous factors are a major yet less discernible factor. Therefore, it is dependent on the particular aspect of control that policy health actors are faced with, will direct the type of policy development processes undertaken. If the policy is within the control of Health, involves input to cross portfolio policy development, or involves input to intergovernmental policy evelopment. Amongst the many structures used to describe the policy processes Walt (1994) describes the most commonly used framework as a four step continuous cycle that moves through (1) problem identification and issue recognition/definition, (2) Policy formulation with clarification of policy issues and preferred options, (3) policy implementation (4) policy evaluation and review. Consultation occurs throughout this cycle. This was expanded upon in the NSW Health Department State Health Publication (1998) to include; a release of formal discussion paper and the evelopment of final policy paper, as two separate activities coming after policy formation. These two additional steps have become necessary, as the intended policy must be available to the general public and special interest groups, to illicit their views before it is adopted and sent before cabinet for approval. NSW Health Department State Health Publication (1998) provided twelve guidelines that will further assist in the rational process of a sound policy development process and promote the production of effective and high quality policy documents. These ecommendations places emphasis on the need to have prompt Justification about the reason for the policy, unambiguity as to who holds power over the final document to initiate the policy development process, and selecting appropriate person(s) and resources to undertake the process effectively within the required timeframe. There must also be consistency between micro and macro policies of the Government. NSW Health Department State Health Publication (1998) also urges that not only there should be timely participation of affected government stakeholders, there should be he lively discussion with Health Services and other key external stakeholders. Another area where Trinidad and Tobago can benefit greatly from is the recommendation that adequate testing be given for relevant options before implementation. Head (2008) would argue that for a truly rational approach to health policy making to occur, it must be centered on Evidence-based policy (EBP) making. This concept of EBP sits squarely in the Rational or Synoptic model, and reflects more of an aspiration that a state should acquire, rather than an accomplished outcome hat could be examined. The only way decision makers can realistically and comfortably make sensible selections would be through adopting EBP as a measure to guarantee dependability ot intormation regarding the efficiency and ettectiveness of adopting a particular course of action over other possible alternatives. It was under Prime Minister Blair, the then British Government saw the need for a more rational approach to policy making. They encouraged employing EBP as key trait in the new strategy to develop a logical method to policy development that will bring ncreased policy capability (UK Cabinet Office, 1999a cited in Head, 2008 p. 15). In Australia, Prime Minister Rudd (2008 cited in Head, 2008 p. 15-16) understood for there to be successful governance, decisions must hinge on ESP. In his 2008 address to the Heads of Agencies and Members of Senior Executive Service, he stated The Government will not adopt overseas models uncritically. Were interested in facts, not fads. Australian policy development should be informed by the best of overseas experience and analysis. Other measures include identification and resolution of inancial and staffing implications of policy. Consideration and response to consultation, communication, industrial and implementation issues. Provide for effective implementation and evaluation with performance targets, planning requirements and accountability arrangements identified. Effective use of Cabinet, Budgetary and Legislative processes of Government where required. Having reviewed these many components, hindrances, and best practices of rational policy making, tackling the fundamental question of the reality for there to be a rational approach to health policy-making? And is evident in Trinidad and Tobago, the answer will have to be no. This has become clear as in many instances the required processes that need to be undertaken are not always available to the policy makers. Issues with fully adopting a rational approach begin to surface almost immediately. From simply identifying what exactly the health system is faced with, to defining goals to address those problems, a plethora of impediments already exists to derail the intended logical policy process. Making rational decisions are also constrained by the decisions made by past administrations. This can be seen with the previous administration in Trinidad and Tobago, with the introduction of the CDAP. With such a program providing free prescription drugs for chronic diseases, often benefiting lower income groups, it would have been almost impossible for the new administration to reverse it, even after making negative statements towards such a program while in opposition.

Tuesday, January 21, 2020

Comparing Crime and Punishment and Taxi Driver :: comparison compare contrast essays

Crime and Punishment and Taxi Driver He is a man whose psychological workings are dark, twisted, horrifying, and lonely. He is an absurd, anti-hero who is absolutely repulsed by his surroundings, and because he is unable to remove himself from them, he feels justified in removing other people. This profile fits Travis, portrayed by Robert DeNiro in Scorsese's film "Taxi Driver,", and Raskolnikov, the main character of Dostoevsky's novel Crime and Punishment. Their revulsion for life leads both men to commit cold-blooded murders, but the story lines contain major differences. By contrasting these differences and comparing the common themes of the classic and the film, we may come to a clearer understanding of the purpose of both stories. The root of both Travis' and Raskolnikov's problems is their complete and utter disgust with the world around them. Travis is a New York City cab driver who drives everywhere and picks up anyone. It doesn't matter to him if the customer is a prostitute who uses his backseat as her workplace. He just drives around with a glazed look of indifference in his eyes, while inside, his heart is overflowing with rage. In contrast, Raskolnikov is an ex-student living in St. Petersburg during the mid 1800's. He is extremely poor, and therefore lives in an area called the Haymarket, where all the whorehouses and bars were located. Every time he goes out, he walks past the dregs of society, which fills his heart with hatred for everyone and everything. Both characters see the world to be completely evil and devoid of all goodness, and this existential view drives them to become exactly what they so desperately hate. Their revolt against ugliness pulls both characters towards the most ugly of all deeds - murder. Travis dreams that "someday a real rain will come and wipe this scum off the streets." He feels some sort of divine calling to actually become this "real rain." Similarly, Raskolnikov plots to sacrifice one "louse of a human being" who is "no good to anyone" for the benefit of thousands. Out of this scheme he derives his Extraordinary/ Superman theory that states that humans are divided into the ordinary and the extraordinary, the men and the supermen.

Monday, January 13, 2020

John Winthrop “a Model of Christian Charity” (1630)

John Winthrop â€Å"A Model of Christian Charity† (1630) Daisha A. Powell South University John Winthrop â€Å"A Model of Christian Charity† (1630) The Puritans had different beliefs from the Pilgrims in which they jilted separatism postulating the Anglican Church could be saved. They wanted to build churches to function as models for the English Church. John Winthrop on the eve of the puritans’ settlement of Massachusetts Bay wanted to have a structure of government and social order already established.John Winthrop stated that the only way order and success of a colony is rooted in a belief in God, communal covenant and the mindset the life of hard work is God’s plan. First, John Winthrop believes that life itself was predestined and with conformity and belief in God and his almighty power and glory, preservation lies within. Secondly, all men are equal and no one is more honorable, more wealthy, or superior to another. All men shall be tight knit in the bond of brotherly love.Thirdly, bound by an agreement between God in which God makes certain promises and requires certain behavior in return, man has a choice. By choosing to live by God’s word man will continue to be blessed with countless blessings but deciding to live life outside of this covenant God will break out in wrath as an act of revenge. John Winthrop goes on to say that man must work as one, entertain one another, and be willing to help each other with meekness, gentleness, patience, and liberality.He views his community as one of the same body and so when one person suffers everyone suffers or supply that person with some sort of relief. By keeping the unity in the bond of peace the Lord will be pleased with their actions and they would see much more of his omnipotent power, wisdom, and goodness. John Winthrop believes that they will have a new profound belief that God is among them when ten of them will be able to resist a thousand of their enemies. He consis tently prompted his people of heir mission and encouraged them to satisfy their divine obligation to become a beacon of godliness for all mankind, and that they should be as â€Å"a city upon a hill† (Stone, 2012). They will witness things unheard of and become a testimony to others, believers and non-believers. These testimonies will serve as proof of God’s existence and of his power. In conclusion, man should love, worship, serve, and obey the Lord as well as love one another, walk in His ways, live by His commandments, ordinance, laws, and by the covenant.By cleaving to God, he will give an abundance of blessings to life’s pleasures and profits. This commitment to God ensures a life of prosperity.References Goldfield, D. (2011). The American Journey: A History of the United States. Upper Saddle River, NJ: Prentice Hall. Stone, P. (2012, October). Worlds Apart, Translation and Adaption 1600-1685. The American Journey. Lecture conducted from South University, N ovi, Michigan.

Sunday, January 5, 2020

Nursing Care Plan Impaired Parenting - 1414 Words

Impaired Parenting is a nursing diagnosis that should be considered for all parents who are having a child. There are many classes available to new parents that can be taken before childbirth takes place. These classes will inform parents how to take care of their newborn child, as well as, mentally prepare each family member what their role will be with the birth of their new child. The National Center on Shaken Baby Syndrome says that in 2003, 1,300 infants in the United States died from being shaken (Tumlin,2010). Most of these deaths could have been prevented. If parents fail to take parenting classes before birth there is a higher chance they may be impaired for the obstacles they will be facing upon having a child. Impaired Parenting†¦show more content†¦This intervention is necessary so that the mother can calm the baby down when crying. The third intervention set in place to help this family was that the nurse would allow plenty of time for the infant to bond with th e family while at the hospital. This intervention was necessary so the parents can ask any questions they might have to the nurse while the nurse is present to help make the parents more comfortable when bringing home their newborn. The first time the mother held the infant, the mother was stiff and did not move at all while the infant was in her arms. By the end of the clinical experience that day, it was apparent that the mother had become more comfortable handling her newborn by the way she was inspecting and touching the newborn. The mother became less tense and began holding the newborn with much more ease. The parents had decided to bottle feed the baby and after receiving some education on how to properly do so from the nurse, both parents were doing a sufficient job of bottle feeding. This type of evaluation is what the nurse likes to see. If the nurse evaluates the patient and is not seeing any improvements, she would then need to go back, modify the interventions, and try something different. An article by Janis M. Campbell from the Journal of Community Health Nursing, titled â€Å"Parenting Classes: Focus on Discipline,†Show MoreRelatedJean Watson Case Study1273 Words   |  6 Pagestheory-based nursing practice that can improve health and healing in stressful life circumstances, such as in the case of Elizabeth Jefferies is a divorced 46-year-old mother of two children, who is going through some life stressors/ challenges; psychological, physiology, and spiritual challenges. E.J.’s case study will be reviewed from the objective and feasible subjective data, identify relative nursing diagnoses, identify and establish outcomes with interventions, implement plan of care, and evaluationRead MoreSample Care Plan Psych4533 Words   |  19 PagesPSYCHIATRIC NURSING MAJOR PLAN OF CARE ASSIGNMENT Guidelines: 1. 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Does the adult have the ability to care and guide the next generation? Generativity has a broader meaning then just having children. Each adult must have some way to satisfy and support the next generation. According to Erikson, ARead MoreSymptoms And Symptoms Of Inflammatory Bowel Disease ( Ibd )1316 Words   |  6 Pagesoccurrence of the disease is largely influenced by environmental factors (Lichtenstein Scherl, 2011, p.77).This has been a life changing experience for him and as a result he is a completely different person as his digestive system relies on his self-care. Impact: Mr. A and his family has to pass through emotions, fear and uncertainty as they were unsure what to expect when the diagnosis is complete. Mr. A and his family did not want to hear the bad news and also believed that their religious faithRead MoreTeaching A New Family About Shaken Baby Syndrome1920 Words   |  8 Pagesat Children’s Hospital of Colorado. Baby Haven was born at 34 weeks gestation to a mother who had used alcohol, marijuana and tobacco while pregnant. Additionally, she claimed to have not known she was pregnant until July and did not seek prenatal care until September, one month before the birth of baby Haven. The birth mother made the choice to put Haven up for adoption. I met the adoptive mother and father while caring for Haven the day before her discharge. Although she was premature and born