Health Policy and the Bureaucracy: Politics and Implementation

Abstract

In the past 50 years, the federal government has undertaken a dramatically expanded role in the health sector of our society. Many of its expanded initiatives have been based on relatively brief laws that set a broad policy direction but require extensive implementation actions by the executive branch or its designee. InHealth Policy and the Bureaucracy, Frank Thompson examines the way the bureaucracy shapes and effects the program by the way it implements the underlying law. Thompson's objective is a worthy one. Historically, the politics of health legislation have received considerable attention; the politics of health policy implementation have received less systematic attention. In his initial chapter, Thompson establishes a reasonable theoretical framework for examining policy implementation. Unfortunately, he then attempts to describe the implementation of eight major health programs consisting of The Hill Burton hospital construction (15 pages), Health Planning and Resources Development (20 pages), Health Maintenance Organizations