The process of health policymaking in the United States can be discussed from two different perspectives which provide the opposite contexts for policy development. These perspectives are the pluralist and elitist ones. The pluralist and elitist perspectives differ in relation to the discussed impact of interest groups on the procedure of health policymaking in the United States. To understand the differences in these two public perspectives which are important for the policy development within the society, it is necessary to create the matrix to differentiate the perspectives and to focus on each perspective with references to the concrete examples of the interest groups’ role in the process.
The Differentiation between the Pluralist and Elitist Perspectives
The pluralist perspective is based on the idea of representing and supporting multiple interests of the specific interest groups operating within the industry. In spite of the fact that these interest groups can compete with each other in the market or in the industry, they should be equally involved in the process of the health policymaking because of the necessity to affect the policy development while meeting all the interests of the public (Longest, 2010, p. 42). As a result, according to the pluralist perspective, the equal participation of such interest groups as the American Medical Association and the American Nurses Association in the process of the policy development creates the necessary balance in addressing the interests of the groups, while satisfying the interests of the involved public (Myers, 2010, p. 9). Thus, the interests of the American Medical Association and the American Nurses Association become addressed, and there is no dominant interest to influence the policy development. Physicians, nurses, and patients’ interests can be discussed as equally satisfied.
On the contrary, according to the elitist perspective, only interests of one or few influential groups should be taken into consideration while developing the policy. These groups form the elite within the industry and have the necessary power in relation to the policymaking issues (Longest, 2010, p. 42-43). For example, the American Medical Association can use its financial resources and the power of the political impact in order to influence the policymaking process and respond to the association’s demands.
The Interest Groups’ Roles in Relation to the Perspectives
It is necessary to focus on the role of the above-mentioned interest groups in relation to the pluralist and elitist perspectives. Thus, the American Medical Association and the American Nurses Association operate within one industry, but they develop their positions and activities within different sectors. From this point, the associations’ interests and demands are often different and can be even opposite in relation to each other (Wynia, 2007, p. 5). However, while discussing and influencing the development of definite policies, these associations can propose certain recommendations within the larger context, paying attention to the interests of several groups within the industry to promote the public’s welfare.
Nevertheless, there are situations when the American Medical Association can act as the leader within the industry and support its dominant interests with references to the governmental support because of responding to the necessary reforms and alternations in the industry (Longest, 2010, p. 42-43; Mello, Abiola, & Colgrove, 2012, p. 893). This position can be associated with the budget issues, development of regulations, and the policy and programs’ implementation when the association accentuates its interests as prioritized.
Thus, the complex process of the pomaking development can be analyzed from two opposite pluralist and elitist perspectives which emphasize the roles of different interest groups in the process.
Longest, B. B. (2010). Health policymaking in the United States. USA: Health Administration Press.
Mello, M., Abiola, S., & Colgrove, J. (2012). Pharmaceutical companies’ role in state vaccination policymaking: the case of human papillomavirus vaccination. American journal of public health, 102(5), 893-920.
Myers, C. (2010). Being there: Policymaking and nurses. Tennessee Nurses Association, 73(3), 9-10.
Wynia, M. (2007). Public health, public trust and lobbying. The American journal of bioethics, 7(6), 4-7.