Punctuating the equilibrium: an application of policy theory to COVID-19

Abstract

COVID-19 has taught us that, when inadequately addressed, preexisting policy problems (e.g. weak coordination of healthcare and gaps in income supports) exacerbate the cost of crises (including deaths) and make policy responses more difficult. On a more hopeful note, the pandemic has also revealed that policymakers and bureaucrats, reputed as defenders of the status quo and glacially paced, are capable of moving nimbly when seized with necessity. This manuscript draws on Baumgartner and Jones' punctuated-equilibrium theory to analyze and demonstrate how policy responses to the pandemic, largely in Canada but also globally, were shaped by preexisting problems (periods of equilibrium). It then raises the question: Will future policy reflect lessons learned through COVID-19, to not only mitigate risks from further crises, but also tackle many other policy challenges? It would seem we can no longer accept the excuse that problems are too complex or time-consuming to tackle.

Building health system resilience in the context of primary health care revitalization for attainment of UHC: proceedings from the Fifth Health Sector Directors’ Policy and Planning Meeting for the WHO African Region

“…Naturally, COVID-19 has afforded lessons in policy development, including ensuring policy solutions are strategic and forward-thinking, as opposed to short-sighted solutions, and the need to focus on equity, effectiveness, and efficiency, where relevant [ 18 ]. Attention should be paid to moving the health system from one of responding to the crisis at-hand to being more proactive and planning upstream, leaving no ne behind.…”

“…Attention should be paid to moving the health system from one of responding to the crisis at-hand to being more proactive and planning upstream, leaving no ne behind. “Pre-existing policy problems not adequately addressed exacerbate the cost of crises (including deaths) and make policy responses more difficult” [ 18 ]. While discussed more broadly (e.g.…”

Doctor Retention in a COVID-World: An Opportunity to Reconfigure the Health Workforce, or "Plus ça change plus c’est la meme chose"? A Response to the Recent Commentaries

“…Until the COVID-19 pandemic struck Ireland, the media had a more ambivalent attitude to doctors than to nurses, who are invariably portrayed as frontline heroes. Now may be the opportunity to reframe media and public perceptions of the medical profession, changing the 'policy image, ' which Baumgartner and Jones, as reported by Amri and Drummond, 26 define as "how public policies are discussed in public and in the media. " The radical health systems and workforce changes that are required go far beyond renegotiating the terms and conditions of consultants' contracts.…”

Rapid, centralised decision-making in a higher education emergency

“…Policy equilibrium was punctuated by rapidly changing demands. Amri and Drummond (2020) found that in such circumstances, "policy-makers and bureaucrats, reputed as defenders of the status quo and glacially paced, are capable of moving nimbly when seized with necessity" (p. 33). Jones's (1991, 2010) punctuated equilibrium theory accommodates such demands.…”

“…True et al (2019) suggest that such policy punctuations "spring from either a change in preferences or a change in attentiveness" (p. 163). Punctuated equilibrium theory has been used to gain insights into shifts arising from the COVID-19 pandemic in health policy (Amri and Drummond, 2020), environment policy (Garfinkel, 2021) and quarantine policy (Moloney and Moloney, 2020).…”