Brokering Health Policy: Coalitions, Parties, and Interest Group Influence

Abstract

Assuming a position as broker between disconnected interests is one way for an interest group to influence the making of federal health policy. This study demonstrates how groups use their connections with political parties and lobbying coalitions to augment their brokerage positions and enhance their influence over policy making. Evidence is drawn from statistical analysis of 263 interviews with health policy elites and a qualitative case study of the debate over the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. The results explain, in part, how interest groups play their brokerage roles as dispersed actors in a decentralized system, rather than as central mediators that intervene in a wide range of policy disputes.

Two-mode brokerage in policy networks

“…al., 2006, broker organization (Chaskin, 2001), and many others (Collins-Dogrul, 2012). These brokers can profit from increased exposure to different ideas, knowledge, or resources (Burt 2001), boosted reputations and influence (Heaney 2006), and monopolizing communication pathways (Chaskin 2001). However, these roles are not without costs and potential pitfalls; brokers are often taking the highest risks when working with disconnected parties that can be suspicious of others or even hostile (Stovel and Shaw 2012).…”

Interest group influence on US policy change: An assessment based on policy history

“…The findings do not extend to less significant policy change. 5 One notable exception is Michael Heaney's (2006) analysis of health policy coalitions. 6 I found few significant differences in the extent or type of interest group influence based on the type of author or their discipline.…”

Lobbying Mediocrity

“…3 But by 2003, the AMA's political influence was ranked inferior to both the American Association for Retired Persons (AARP) and the Pharmaceutical Research and Manufacturers of America (PhRMA). 4 From the perspective of someone who has met with over a thousand lobbyists while working in Washington, DC, I can tell you that physician problems with public policy advocacy are numerous and complex. Our biggest problems, however, are that our political attendance is poor, our lobbying strategies are outdated, and we are overly apathetic and negative about the political process.…”