Week 6: Bad policy

Political debates and the media play important roles not just in driving high-level goals and shaping discourse in different areas but in having an impact on policy design and implementation. While this might help in legitimating policy, public attention can often focus on outliers or spurious data and lead to efforts to bypass existing mechanisms and produce new policies and sometimes quite decidedly poor policy outcomes.

Consider the experience of UK healthcare policy over the past decade.  There are several examples where discredited evidence has distorted policy debates often leading to a media focus on issues that are either of negligible impact or are outright counterproductive.

In 2010, the Conservative entered government with a pledge to create a Cancer Drug Fund driven by concerns that treatments for certain rare cancers were not being funded thereby overriding the recommendations of the National Institute for Clinical Excellence (NICE), which would normally set policy. Unsurprisingly, apart from the evocative personal stories, a leading advocate of greater public spending was the Association of the British Pharmaceutical Industry. The Fund ended up paying out £1.27bn from 2010 to 2016 even though only 18 of the 47 treatments funded prolonged the patient’s life, and, of those, patients’ lives were extended only by an average of three months.  Finally, in 2016, the Cancer Drug Fund was brought within the remit of NICE.

Andrew Wakefield, a now-discredited British physician (who continues to practice in Texas) and colleagues published an article in The Lancet in 1998 that gave legitimacy to the possible link between autism and vaccines before finally being retracted in 2010 for being ‘utterly false’.  He was later ‘struck off’ by the General Medical Council but the story was championed by the Daily Mail (the most popular newspaper in the UK!) and has, unsurprisingly, led to a resurgence in measles cases.  Public health officials continued to make the case for immunisation, but leading politicians were silent and Tony Blair famously refused to say whether his son Leo had received the MMR vaccine.  To help redress the situation, some school districts have tried to mandate immunisation before admitting a child.

Other non-health examples include the Hoy No Circula policy in Mexico City, designed to address pollution led residents to purchase multiple older cars rather than one environmentally friendly vehicle.

Of course, there are many reasons for ‘bad policy’ apart from problems with the evidence itself, including interest groups engaging in rent-seeking behaviour, voters disliking policies that result in short-run costs even if there are longer-term benefits, and policy-makers not appreciating unanticipated effects or oversimplifying causal chains.

Please find an example of a ‘bad policy’ from your preferred sector and/or home country and briefly describe why it is a ‘bad policy’, what led to the policy failure and what measures might have been taken (or were later taken) to try to address the policy failure.