Ingredients for Good Health Policy-Making: Incorporating Power and Politics into the Mix

Document Type : Book Review


Department of Public Administration and Public Policy, American University, Washington, USA


Main Subjects

Eggs, flour, sugar, butter, baking soda, milk, and vanilla extract—all ingredients necessary to make a delicious cake. Similarly, good health policy-making can only be successfully pursued and understood by accounting for all of its basic ingredients, including the role of politics and power. Otherwise, the result is simply not good.

In the second edition of Making Health Policy, respected health policy experts Buse, Mays, and Walt have crafted the ultimate health-policy-making “cookbook”—an essential read for any individual seeking to better understand how a health policy emerges and which factors contribute to its success or failure. However, rather than predominately focusing on examining the content of policy—an approach typical of other health policy books—the authors provide the analytical framework needed to consider and bring politics and power, two essential ingredients, to the forefront of any health policy examination.As illustrated by the authors, the role of politics is overwhelmingly pervasive in the emergence, design, execution, and evaluation of health policy. Their work thoroughly explores the role of politics and power in determining, among many other processes in health governance, which health issues receive attention on national agendas (p. 66), how networks of interest groups and government actors form around a health issue (p. 108), the manner in which front-line health workers perceive and chose to implement proposed policies (p. 133), and which health program evaluation findings are utilizedand translated to policy (p.176). In addition, each chapter, with its own collection of related theoretical constructs and examples, provides a critical foundation to begin answering important questions that have historically not received adequate attention by the public health community: Why do some health issues receive priority over others? How can we understand and study power in a health system? Which sorts of interest groups are most influential? Why is evidence-based policy-making so challenging? ... Read more