Getting to YES. Negotiating Agreement Without Giving In

Although the views expressed in the paper are those of the author(s), each of the papers was subjected to an independent peer-review process. The Commission would like to thank the Institute of Health Services and Policy Research (IHSPR) of the Canadian Institute of Health Research for their oversight and administration of the peer-review process for these papers. The work of the authors, the reviewers and IHSPR will serve to make these papers an important contribution to the Commission's work and its legacy. Bibliography 27 iii Highlights Introduction Distinction between simple, complicated and complex problems Health care systems are complex They have been treated as complicated Complicated solutions have not worked We will consider how to intervene in complex systems Complex View of Canadian Medicare Before Reforms Canadian health care as infrastructural Canadians among most satisfied with system up to 1990s: ranked first Federal transfers administered by a staff of 23 Five values of the Canada Health Act (CHA) broadly deeply entrenched The Process of Deterioration A steady decline in public confidence Everyone is more unhappy: system destabilized Resource allocation issues remain Five principles of CHA threatened Four clusters of tensions remain despite many interventions Why We Need a New Perspective on Health Complicated solutions to complex problems have failed Expert advice is too narrowly focussed Unforeseen consequences when advice was implemented Complex perspectives are needed v Executive Summary This paper begins by distinguishing simple, complicated and complex problems. In simple problems like cooking by following a recipe, the recipe is essential. It is often tested to assure easy replication without the need for any particular expertise. Recipes produce standardized products and the best recipes give good results every time. Complicated problems, like sending a rocket to the moon, are different. Formulae or recipes are critical and necessary to resolve them but are often not sufficient. High levels of expertise in a variety of fields are necessary for success. Sending one rocket increases assurance that the next mission will be a success. In some critical ways, rockets are similar to each other and because of this there can be a relatively high degree of certainty of outcome. Raising a child, on the other hand, is a complex problem. Here, formulae have a much more limited application. Raising one child provides experience but no assurance of success with the next. Although expertise can contribute to the process in valuable ways, it provides …

https://betterevaluation.org/sites/default/files/ComplicatedAndComplexSystems-ZimmermanReport_Medicare_reform.pdf

Complicated and Complex Systems: What Would Successful Reform of Medicare Look Like?

(1980). Speaking Truth to Power: The Art and Craft of Policy Analysis. Journal of Economic Issues: Vol. 14, The Papers of J. Fagg Foster, pp. 1029-1031.

Speaking Truth to Power: The Art and Craft of Policy Analysis

The Conceptual Representation and the Measurement of Psychological Forces

The City in History. Its Origins, Its Transformations, and Its Prospects

Preface. Section I: Evaluation Methods. 1. Methods for Evaluating the Return on R&D Investments A. Link. 2. The Use of Case Studies in R&D Impact Evaluations G. Kingsley. 3. Bibliometrics as a Tool for Analysis of R&D Impacts J. Melkers. 4. Co-Word Analysis R. Kostoff. 5. Peer Review and Evaluation of R&D Impacts B. Bozeman. 6. Patents and the Evaluation of R M. Papadakis. 7. Operations Research Contributions to Evaluation of R&D Projects S. Bretschneider. Section II: Evaluation in Practice. 8. Evaluating Federal R&D in Canada A. Barbarie. 9. Evaluating Federal R&D in the United States D. Roessner. 11. Evaluating the Industrial Relevance of Public R&D Laboratories R. Dalpe, F. Anderson. 12. U.S. Evaluation of Strategic Research: Closing the Gap with Europe and Japan S. Cozzens. 13. The Temporal Dimension of R&D Evaluation: Incorporating Spin-Off Benefits M. Brown, C.R. Wilson. 14. Criteria for Evaluating Research Projects and Portfolios H. Averch. 15. Annotated Bibliography on Evaluation of Research, 1985-1990 H. Averch. Index.

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A systems-based approach to policymaking