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Public Engagement in Healthcare Policy Formulation: Contexts, Content, and Identity Construction

Howe, Samantha Anne
http://rave.ohiolink.edu/etdc/view?acc_num=osu1376662937

Abstract Details

2013, Doctor of Philosophy, Ohio State University, Public Policy and Management.
Background: The passage of the federal Patient Protection and Affordability of Care Act (PPACA) has forced a renewed discussion of the appropriate cost, coverage, and organization of health insurance at the state level. In attempting to address the federal requirements public officials must grapple with complex, technical and politically treacherous issues. In order to address these demands, institutions may find that citizen engagement in the decision process is especially useful. Methods: First, this dissertation introduces a typology of contexts for participation. The typology informs theory and practice and is drawn heavily from the literatures of political science and public administration. It is then supported empirically through application to a sample of case studies already in these literatures. This dissertation then utilizes a case study approach to investigate the application of participatory processes to healthcare. The state of Oregon is seeking to include citizens in the decision-making process as they set about to meet the requirements of the new federal health care laws. Utilizing content analysis of town hall meetings and interviews with decision-makers this research investigates the qualities of citizen participation, including in what ways citizens speak about health care and how officials interpret this input given the highly expertise dominated nature of the discussion. Implications: The typology of this dissertation provides numerous implications for participation scholars; it suggests directions for future research and indicates new potential for utilizing research that has already been conducted. The Oregon case study of participation similarly suggests new avenues of research. This case was chosen because it is in an area in which the outcomes are typically highly technical and expert driven. Yet, it is also one of many areas in which citizens are demanding more control. This implies a discussion that not only must attend to a complex and technical subject matter but also to the rich, value-laden nature of the decisions to be made. The case study approach makes it possible to identify the mechanisms for navigating these multiple, coinciding conversations and the results thereof. Finally, this research suggests new trends in how women participate in healthcare discourse. The findings suggest that concerns about the representativeness of participants should remain a part of the bureaucratic consciousness. Caution regarding who participates and how remains necessary in order to avoid the risk of process capture by those who already retain power.
David Landsbergen, JD, PhD (Advisor)
Jill Bystydzienski, PhD (Committee Member)
Michael Neblo, PhD (Committee Member)
Sandra Tanenbaum, PhD (Committee Member)
699 p.
Health Care Management; Political Science; Public Administration; Public Health; Public Policy
citizen participation; civic engagement; health policy; gender politics

Recommended Citations

Citations

  • Howe, S. A. (2013). Public Engagement in Healthcare Policy Formulation: Contexts, Content, and Identity Construction [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1376662937

    APA Style (7th edition)

  • Howe, Samantha. Public Engagement in Healthcare Policy Formulation: Contexts, Content, and Identity Construction. 2013. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1376662937.

    MLA Style (8th edition)

  • Howe, Samantha. "Public Engagement in Healthcare Policy Formulation: Contexts, Content, and Identity Construction." Doctoral dissertation, Ohio State University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=osu1376662937

    Chicago Manual of Style (17th edition)

osu1376662937
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© 2013, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.