Respond to two (2) of your classmates with further questions, constructive criticism, and/or connections to your own perspective on how different professions and different stakeholders view societal issues and concerns that require governmental involvement. What are some of the health equity implications of differing values, views, and perspectives of culturally different beliefs and practices?
Respond to the two posts separately.
To me, Stone’s¹ statement that “science cannot settle questions of meaning” (pg 381) is absolutely and undeniably true. Many difficulties in resolving policy conflicts result not from data and scientific fact, but the interpretation thereof. While data and facts are necessary to drive policy forward and give us the evidential basis to make recommendations for policy, they cannot decide what is or is not important to a group, a community, or a nation. Science can only describe information, it cannot interpret it- and often it is the details that matter most. What drives policy, alongside data, is need, and it is up to the particular community to decide their needs. “Need” is so subjective and so variable, that science cannot define it. It is up to the community to define need and up to science to find evidence to back that need. Finally, it is up to policy makers to find solutions to that need in a way that serves the community is equitable and just.
I do think, however, where science can assist is when members of a community have differing interpretations of a problem. For example, recently in my town, a doctor wanted to get a license to administer medication assisted treatment (MAT) for opioid detox. This means that the doctor wanted to be able to prescribe medications such as Suboxone and Vivitrol which have proven to be effective at managing withdrawal from opioids as well as cravings for them during early sobriety. To the recovery community, this is a huge benefit to individuals looking to begin living a sober lifestyle, as these medications have been shown to assist with an individual’s recovery effort. However, community members responded poorly to this licensure as they feared a rise in crime in the neighborhood due to an influx of individuals who use substances. Clearly, the individuals living in the immediate area of the proposed MAT clinic and the recovery community represent to very divergent interests.
Evidence, however, points to MAT programs not bringing an influx of crime into areas where they serve individuals. To the contrary, individuals are less likely to engage in criminal behavior or relapse on their substance of choice². This evidence may not be enough to sway those who have deeply rooted ideas of who and what an individual who uses drugs is, but it is evidence that can be used to inform those who wish to be informed.
Stone D. Policy paradox: The art of political decision making. 3rd edition ed. New York, NY: W. W. Norton & Co.; 2012:381
Melin Y, Eklund M, Lindgren B. Experiences of living with opioid dependence: An interview study among individuals participating in medication-assisted treatment. Issues Ment Health Nurs. 2017;38(1):9-17. https://doi-org.une.idm.oclc.org/10.1080/01612840.2016.1235638. doi: 10.1080/01612840.2016.1235638.
This paragraph definitely resonates with me on a personal level. I agree with what Stone is saying, that the essence of what people care about and are willing to fight for have everything to do with your identity, personality, and beliefs. We see evidence of this now in our country with the presidential election. The cause for conflict and/or difference of opinion is the beliefs and identity of each individual. Now more than ever we see our country divided based on what strong beliefs we hold such as the Black Lives Matter movement versus Blue Lives Matter. Universal healthcare versus private insurance. This is a complex problem of course but there are people who clearly take one side versus the other due to differences in religion, personhood, identity, war, and the proper relationship between religion and government.1 Policy is made for a reason, to solve a problem that is evident in your community. This reflects the author’s statement of “What communities decide about when they make policy is meaning, not matter.”1
When a community creates a policy, it is usually made based on “evidence” or real-life incidents. Policy is often created as the solution to a problem the community faces. While evidence is important to back up a policy and provide truth to it, the basis of creating the policy can be the answer to “Why does this problem matter? Why do we care? Who is affected?”. Scientific evidence gives us the information to back up our policies based on these questions.
To address differing interpretations of a societal problem, I would point to the evidence. This is where scientific evidence comes in to play in policy making. I once heard a quote that said, “the good thing about science is it’s true whether you believe it or not”. Thus, if you can accurately back up your solution with scientific evidence, you can explain the reasoning of the policy. I would first begin by addressing the problem, providing statistics and evidence that the problem exists and how prevalent the problem is. Then I would explain the different policy options on what could solve the problem, again by referencing scientific evidence. Policy is a choice, and with that choice means there are many possible solutions to any particular problem.
A topic that is still an issue in government policies today is Universal Heathcare. There are strong oppositions to this as well as many people in favor of the policy. The evidence is there, as there are many countries that offer Universal Healthcare, such as the United Kingdom, Austria, Italy, Sweden, Switzerland, and Canada, to name just a few. The United States spends more on healthcare than all these countries, but we are not even close to having the best health care. Actually, we are ranked 15th in the world in healthcare but we are also known for having a very unhealthy population. What is the solution? There are many proposed solutions not just involving healthcare but health in its entirety. Again, this is where we pull evidence from other countries and how their healthcare is organized. According to the World Health Organization, France provides the best overall healthcare in the world. Policymakers can study why their healthcare system works, what role the government must have, what options that gives the people, etc.
Stone D. Policy Paradox: The Art of Political Decision Making. 3rd ed. WW Norton; 2012.
The original post assignment was : Stone writes (pg 381) “What people care about and fight about are interpretations of personhood, identity, economic welfare, war, and the proper relationship between religion and government. What communities decide about when they make policy is meaning, not matter. And science can’t settle questions of meaning.”
Write an original contribution about what this paragraph means to you. What does it say about the role of “evidence” in the policy process? How might you address differing interpretations by various audiences of a societal problem when thinking about how you will describe your problem and the potential policy options to address it? Describe a situation that involves differing views on “what people care about” and what evidence might be used to support various interpretations of the problem or proposed solutions.