1.2 Focus, Focus, Focus

Agreeing on a limited number of goals to pursue is important in complex systems involving multiple decision-makers

Several factors influence change, especially when change involves attracting human and financial resources to your cause.  Setting a goal helps explain why others should care about what you want and can, in some circumstances, influence them to shift their attention from others’ goals to help you achieve yours.

Achieving this shift in attention to your goal is especially crucial in, but not exclusive to, health care, where resource allocation decisions are affected by at least 5 factors: 1) scarcity of resources; 2) perception of need served by the program; 3) program effectiveness; and 4) perceived personal responsibility for illness. These four factors are further influenced by the political ideology of the decision maker.[1]


Stated differently,

  1. Do we have money? or How much money is being spent on this issue right now?;
  2. Who will benefit? or Who is experiencing an unmet need right now?
  3. Do we know what works? or Is what we are spending money on (right now) working? If yes, for whom, in what setting(s), and in what percentage of cases?
  4. Have potential beneficiaries contributed to their illness or condition?
  5. What do decision-makers believe regarding spending public monies on health?

[1] Adapted from Skitka and Tetlock (8,9) in Corrigan and Watson, “Factors that explain how policy makers distribute resources to mental health services.”Psychiatr Serv. 2003 Apr;54(4):501-7, p., 502, https://www.ncbi.nlm.nih.gov/pubmed/12663837; See also: Newman, J. (2014) “Measuring Policy Success: Case Studies from Canada and Australia”in Australian Journal of Public Administration, 73(2).