Policy Players and
Processes
Dye, Chapter 4-5
Kingdon, Chapter 2-4
President

President can affect the course of Health
Care Policy by:

Influencing the Agenda
 President
is considered “very or somewhat
important” by ¾ and “very important” by 31% in a
study by Kingdon

Using Institutional Resources
 Veto
 Hire
and Fire
President

Using Organizational Resources
 Executive
Branch is a “unitary decision making
entity” in contrast to the Legislative or Judicial
Branches

Using Public Attention
 Public
opinion puts pressure on the other branches
to carry out the President’s agenda

Being Involved
 Involvement
beyond the basics, including phone
calls, repeated requests, and letters
Presidential Staff

Includes the staff in the White House and
in the Executive Office
top personal advisors of the President
 members of Executive Office agencies, such
as the Domestic Policy Staff, Council of
Economic Advisors, and the OMB.


Plays a very important role in agenda
setting.
Presidential Staff

Agenda Setting

In the distinction between the agenda and the
alternatives, the presidential staff usually deals with
the alternatives.



The President makes up the agenda, makes the very
important decision and then sets the tone for the Presidential
Staff to follow.
The Presidential Staff deals with the detailed negotiation of
the issue with the departments, Capitol Hill, and major
interests groups.
Produces the administration’s proposals and clarifies
the bargaining positions of the administration, then
sends proposals to the legislative process.
Political Appointees

Role on Policy Making



Appointed by President; part of the Administration;
appointees range from cabinet secretaries to head of
bureaus or administrations.
Seen by public as equally important to President
(82% of a study believed that political appointees are
very to somewhat important; 26% believed they were
very important to the political process.)
Political appointees play a key role in placing ideas on
the agenda: They often elevate issues rather than
creating them.
Political Appointees

Downfalls



Political appointees should be critical policy makers,
however, political appointees may become captured
by their agencies or professional civil servants find
ways to circumvent their appointed superiors.
Political appointees have a short length of service
time, which can lead to more rapidly made decisions,
resulting in good and bad.
The president’s priorities usually set the policy
agenda for appointees although appointees may
sometimes try to persuade an issue to the president.
Political Appointees

Examples



Kingdon: 1979 – top level appointees in Dept. of
Health, Education, and Welfare (p.28)
Appointees can push an old agenda that may be
supported by President to help take welfare recipients
that are persistently poor off of welfare.
American Association of Retired Persons (AARP)
may push an appointee toward their decisions to
uphold and increase Social Security or Medicare.
Civil Servants

Civil Servants
Are specialists in a particular area of policy
 Do not actually set policy agendas but
generate feedback from agendas


Two types of bureaucrats
Line: Concentrates on administering existing
programs
 Staff: Deliberate on researching policy
changes

Civil Servants
Continually working on proposals till
administration is receptive
 Depends upon:

President
 Congress
 Political Appointees


Internal Struggle:
When deadlocked, may leak information
 Release premature proposals

Civil Servants

Civil Servants are important to policy
because:
Longevity: wait till they have a receptive
administration
 Expertise: they have experience from the past
 Iron Triangle: bureaucrats, committees,
interest groups

Interest Groups

Types of Interest Groups
Business and Industry
 Professional
 Labor
 Public Interest Groups
 Governmental Officials as Lobbyist

Interest Groups

Types of Interest Group Activity
Some affects the agenda
 Other activity affects the alternatives
considered by policy makers
 Some is positive, promoting new courses of
government action
 Other activity is negative, seeking to block
changes in public policy

Interest Groups

Interest Group Resources
Their geographical dispersion in
congressional districts throughout the country
 Their ability to mobilize their members and
sympathizers
 Their status or wealth are thought to have an
ability to affect election outcomes

Media
Includes Reporters Columnists, Anchors,
Editors in TV, Newspapers, Magazines,
Internet
 Often misrepresent their own opinions as
public opinions, like an elite group

Media

On the Agenda:





Major influence on agenda setting: issues it reports
on will receive attention from citizens and politicians
Kingdon: Media has less influence on agenda settingmay indirectly affect public opinion but policy-makers
have usually decided if an issue will be on the agenda
or not by the time the media reports on it
Main source of information on public policy issues
Tend to take a liberal stance on issues and to
sensationalize/dramatize them
Can influence viewers’ opinions on new issues but not
as likely to change established opinions on old issues
Media

Health Care:



Media groups would advocate health care reform, a national
health care system or universal care, increased spending on
Medicare and Medicaid, more services to be provided by this
programs, and availability to more people (liberal views)
The media would call attention to cases of extreme poverty and
suffering, appealing to viewer’s emotions and possibly
misrepresenting the problem, focusing on the failures of
Medicaid and Medicare and not the successes
Wilson: Media would empathize w/ the working class and would
depict the average hard-working American who may not receive
adequate health coverage

Also would publicize statistics and figures such as the U.S.’s high
level of health care spending compared to our low life expectancy.
Again, the facts could be distorted. For example, the media would
probably use definitions of poverty that encompass a greater
proportion of the population than the accepted 12.7%
Media

Health Care (cont.)

Media reports would not use technical terms or be too
hard to understand, they would likely use catch
phrases and expressions which the public would pick
up on but may not really understand.


For example, the average American may not know the
difference between the various government assistance
programs
If enough attention is given to health care by the
media, public concern for it will rise and politicians will
be more likely to include it on policy-making agendas.