The Game Doesn't End After Enactment?

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This week's readings pertained to the topics of success and failures of policy after it has been implemented. In particular, (Patashnik) analyzes general interest reforms-meaning a "non-incremental change of an existing line of policymaking intended to rationalize government undertaking or to distribute benefits to some broad constituency"-and specifically details the sustainability of the various policies after their implementation. Patashnik believes that much academic focus and energies are directed towards the environment before and at the moment of implementation of public policies but these efforts and interests wane after the implementation of reform. By analyzing policymaking developmentally through various case studies, including the Tax Reform of 1986, Patashnik sets out to determine how different general interest reforms have evolved after the signing of the bill and to see what effects that institutional shifts, interest-group feedback, and investment feedbacks have on the post enactment trajectories of the various bills and how current and future politicians and political scientists could benefit from such discoveries.

The readings this week are a nice accompaniment to the many selections earlier this semester because they build off the different dynamics that are at play with the creation of public policy, such as interest group activity and polarization of parties. "The game doesn't end after the bill is signed" seems like it could be directed to Kingdon's theory of agenda setting and his discussion of the importance of problems, politics, and political windows in the formation of public policy. The evolution of policies after conception are important to evaluate as they allow for a deeper understanding of the policymaking process and what efforts should be made to ensure that polices will stand in the future with their core principles intact.

My questions correspond to the practicality of Patashnik's practical implications. I don't disagree with his premise of the importance of the evolution of reform legislation and its staying power but I do wonder how beneficial it is for actors of the policymaking process to be concerned with this when they often have to endure the paradoxes that Patashnik cites as ways in which reform is passed but often then leads to the unraveling of said program. Integrating sustainability considerations into policy design is one of the implications put forth by Patashnik and he states that "reformers should select policies that are best not only in a static sense, but that seem likely to generate more, rather than less, social progress over time. " How would President Obama's Affordable Care Act been different if they had chosen a structure that addressed the sustainability of the reform? Would the bill pass if these structural changes were added? Are there aspects of the bill process that did take into account the sustainability or were the changes of the bill more directly tied to just getting the bill enacted?

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I don't know about the reform, but one thing it did address was the sustainability of our health care system. Costs are so out of control, people were "being priced out" of care. It took that realization for interest groups like AMA and the insurance group to sign on. Its too bad things had to get so bad for them to take action. Goes to show, health care really is about preventive medicine and general care as much as innovation and finances. As President Obama pointed out - health care is a social issue, not a capital one.

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