QUALITY / POLITICS   (Q/P)

Political Capacity

    The capacity to resolve problems, to reach agreements and/or workable consensus, in other words to take action, may be a (for further information) scarcer resource than financial means or administrative capability. It is the objective of (for further information) Deising's "political rationality" and the measure of success in (for further information) Lindblom's description of "muddling through." It is a reason for the incrementalism and "muddling through" that Lindblom describes.

    The importance of political capacity increases as conflicts in values and perceptions increase and as uncertainties about conditions, approaches, and outcomes increase (because when choices have a high level of uncertainty they are more highly influenced by opinion, and differences in opinion tend to demand political processes to be resolved). Health policy issues face highly significant differences in values (consider the abortion issues) and deal with high levels of uncertainty (despite the pursuit of scientific medicine). The resulting demands for political capacity can be difficult to meet in political/societal systems of greatly fragmented authority (as in the U.S.) and from a political system expected to carry the burdens of conflicts between economic classes, cultures, races, ages, etc. (again as in the U.S., where these burdens can be heavier than in Western European societies with stronger and more stable class structures but is lighter than in fragile governments such as those in the former Yugoslavia)

    Consider also the importance of political capacity in dealing with health problems that go beyond national boundaries. How effective are international institutions and international cooperation in dealing with new diseases such as AIDS or SARS.