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The public policy issue selected in this case is the health care policy. This is because the United States spends proportionately more money on health care than all other Western industrialized nations. The U. S. health care system follows the model of the mostly private health care system (Patel & Rushefsky, 2006). The need to focus on health care policy can not be ignored because the infrastructure of public health is currently at risk because of general attack on social and public health programs in Congress and in state legislatures throughout the United States. The major concern of external stakeholders in the health care policy is that understanding of expected prices, level of care, price differences may mean that it is difficult for prices to bring about economic efficiency (Patel & Rushefsky, 2006). 

With health care priorities constantly changing as a result of environmental demands, agreements on health care policy are difficult to reach. Ledlow & Coppola (2010) indicated that an understanding of the parity of health care model can be crucial to health leaders for strategically forecasting threats to relationships amid stakeholders, while also balancing priorities among those stakeholders. Health care providers and payers must be cognizant that solutions developed to solve health problems in the current environment may not be valid solutions to tomorrow’s new issues.

The External Stakeholders and How Specifically they Impacted it Health Care

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Understanding the careful balance between stakeholders in health care policy and strategy formulation is very important. Kongstvedt (2012) noted that the reality becomes more important as leaders rise in positions of increased responsibility, from running health care organizations to directing policy for entire health systems. The key stakeholders in health care policy include non governmental organizations, advocacy groups and associations and suppliers. Kongstvedt (2012) noted that “while the numbers of stakeholders in health organizations can be numerous, there are four main types of stakeholders to consider and they include patients, payers, providers and employers” (p. 571). 

Non governmental organizations and advocacy groups as the main stakeholder and other leaders in the health sector must strategically plan and forecast the impact of new policy decisions that may affect the organization (Ledlow & Coppola, 2010). These include patient care, payment arrangements, and external costs, outside stakeholder satisfaction, program efficiency and effectiveness, quality and other policies affecting organization survivability. Advocacy groups and associations and suppliers all play an important role in the operations of any health care organization. Ledlow & Coppola (2010) noted that with any one of the four major stakeholders omitted in the decision making process for health care entity, failure at some level is likely to occur.

Bell (2009) noted that in real world policy making, the policy problem, solutions and evidence can be shifting, poorly defined and ill aligned. Stakeholder conditioned values, culture and historical factors act to shape the choices that must be made. Bell (2009) further says that “the incremental model of policy making accounts this by focusing on the process of bargaining and adjustment among different interests” (p. 8). Support for the health care policy refers to explicit support and also the many ways in which different stakeholders can indirectly support a particular policy direction in different ways.

The impact of each of these external stakeholders

According toRowitz (2009), advocacy activities from major stakeholder associations focus on policy changes necessary to improve the health of the public, not the administration of existing policies. This implies that health care leaders need to balance their advocacy efforts, in which there is room for passion, and their enforcement efforts, which should be dispassionate. Rowitz (2009) says that if the stakeholders have been successful in building trust and credibility in the health care, they will be able to involve the community in both health regulation and advocacy. The major disadvantage of the key stakeholders such as payers and patients is that they tend to focus on the weaknesses of the health care sector rather than its strengths. This leads to fragmented problem solving and partial solutions.

In healthcare policy, stakeholder dynamics are critically important in organizational survival and success. Ledlow & Coppola (2010) indicated that to be successful in the competitive economy of the 21st century, health leaders must be cognizant of stakeholder dynamics and appreciate how the principal actors and components of each interrelate and influence one another. In this context, Ledlow & Coppola (2010) says that health policy success will be in large part determined by developing and maintain relationships with stakeholders by aligning the health organization based on external and internal assessments and evaluation.

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