Policy Makes Politics; Comment on “Modelling the Health Policy Process: One Size Fits All or Horses for Courses?”

Document Type : Commentary


1 Health Management and Policy, Global Public Health, and Political Science, University of Michigan-Ann Arbor, Ann Arbor, MI, USA

2 European Observatory on Health Systems and Policies, Brussels, Belgium


Powell and Mannion’s review of reviews maps the landscape of health policy research, showing a number of problematic and longstanding features. This commentary focuses on the extent to which health parochialism is good for the scientific development of the literature, the extent to which a “tournament of theories” actually develops our understanding of health policy process, and, finally, whether circumscribed theories of the policy process might be missing some of the most important and useful findings of broader comparative politics, which focus on the ways policies create politics over time. It concludes that health parochialism and focus on a circumscribed policy process is not likely to be helpful because it distracts attention from the ways in which coalitions and institutions over time shape politics and policy, a finding explored by scholars of many sectors whose findings should influence health policy research.


  1. Powell M, Mannion R. Modelling the health policy process: one size fits all or horses for courses? Int J Health Policy Manag. 2023;12:7580. doi:34172/ijhpm.2022.7580
  2. Walt G, Gilson L. Reforming the health sector in developing countries: the central role of policy analysis. Health Policy Plan. 1994;9(4):353-370. doi:1093/heapol/9.4.353
  3. Greer S. John W. Kingdon, agendas, alternatives and public policy. In: Balla SJ, Lodge M, Page EC, ed. The Oxford Handbook of Classics of Public Policy and Administration. Oxford University Press; 2015:417-432. doi:1093/oxfordhb/9780199646135.013.18
  4. Schattschneider EE. Politics, Pressures, and the Tariff. New York: Prentice Hall; 1935.
  5. Tuohy CH. Remaking Policy: Scale, Pace, and Political Strategy in Health Care Reform. University of Toronto Press; 2018.
  6. Harris J, Libardi Maia J. Universal healthcare does not look the same everywhere: Divergent experiences with the private sector in Brazil and Thailand. Glob Public Health. 2022;17(9):1809-1826. doi:1080/17441692.2021.1981973
  7. Lynch J. The political economy of health: bringing political science in. Annu Rev Polit Sci (Palo Alto). 2023;26(1):389-410. doi:1146/annurev-polisci-051120-103015
  8. Greer SL, Béland D, Lecours A, Dubin K. Putting Federalism in Its Place: The Territorial Politics of Social Policy Revisited. University of Michigan Press; 2023.
  9. Mahoney J, Thelen K. Advances in Comparative-Historical Analysis. New York: Cambridge University Press; 2015.
  10. Hacker JS, Pierson P. After the “Master Theory”: Downs, Schattschneider, and the Rebirth of Policy-Focused Analysis. Perspect Politics. 2014;12(3):643-662. doi:1017/s1537592714001637
  11. Campbell AL. Policy makes mass politics. Annu Rev Polit Sci (Palo Alto). 2012;15(1):333-351. doi:1146/annurev-polisci-012610-135202
  12. Greer SL, Lynch JF, Reeves A et al. The Politics of Healthy Ageing: Myths and Realities. Brussels: European Observatory on Health Systems and Policies; 2022.
  13. Stewart EA. How Britain Loves the NHS: Practices of Care and Contestation. Bristol: Bristol University Press; 2023.
  14. Burgin E. Congress, Policy Sustainability, and the Affordable Care Act: democratic policy makers overlooked implementation, post-enactment politics, and policy feedback effects. Congress & the Presidency. 2018;45(3):279-314. doi:1080/07343469.2018.1498561
  15. McCann PJ. The Federal Design Dilemma. New York: Cambridge University Press; 2016.

Articles in Press, Corrected Proof
Available Online from 19 August 2023
  • Receive Date: 13 April 2023
  • Revise Date: 15 August 2023
  • Accept Date: 16 August 2023
  • First Publish Date: 19 August 2023