Public health emergency preparedness is an area of growing policy concern with the emergence of new threats. The Centers for Medicare and Medicaid Services issued a proposed rule in 2013 laying out mandates that hospitals and other facilities would have to meet in order to receive federal funding. Hundreds of comments were submitted in response to the rule, which was finalized in 2016. The following study employs content analysis and interpretive policy analysis to investigate the reaction to rule as it was proposed. In doing so, we will consider the different values, beliefs, and feelings regarding the rule that were expressed in public comments submitted in response to it. Along with those aspects, we will also consider the political, economic, and social implications of the proposed rule as expressed in the public comments. These methods will be used to address whether the selected comments represent different coalitions in regard to the CMS rule and if different coalitions represent different themes in their comments. The study will also consider whether the notice-and-comment process, in this instance, is in line with the advocacy coalition framework and whether there were clear winners in the process.Haciendo obligatoria la preparaci on de emergencias de salud p ublica: Un an alisis de la regla CMS La preparaci on para emergencias de salud p ublica es un area de cada vez m as preocupaci on debido al surgimiento de nuevas amenazas. Centers for Medicare and Medicaid Services public o una propuesta de regla en 2013 que establece obligaciones para los hospitales y otros establecimientos que tendrían que cumplir para poder recibir fondos federales. Cientos de comentarios fueron escritos en respuesta a esta regla, que fue finalizada en 2016. El siguiente estudio emplea an alisis de contenido y an alisis interpretativo de políticas para investigar la reacci on a la regla como fue propuesta. Al hacer esto, consideramos los diferentes valores, creencias y sentimientos, que tienen que ver con la regla, que se expresaron en comentarios p ublicos en respuesta a ella. Junto con estos aspectos, tambi en consideramos las implicaciones políticas, econ omicas y sociales de la regla propuesta como fueron expresadas en los comentarios p ublicos. Estos m etodos ser an usados para determinar si estos comentarios selectos representan diferentes coaliciones que tienen que ver con la regla CMS y si diferentes coaliciones representan diferentes temas en sus comentarios. El estudio tambi en considerar a si el proceso de "nota y comentario," en esta instancia, est a alineado con el marco de las coaliciones de apoyo y si hubo ganadores claros en el proceso.PALABRAS CLAVES: Preparaci on de la salud p ublica, Políticas de riesgo y gesti on, Percepci on de riesgos

Developing and strengthening systems for information sharing as well as detecting and addressing dis/misinformation can not only protect capacity for public health emergency preparedness and response, but potentially increase overall community resilience and social capital. More actively involving citizens in the government's collection and sharing of information can generate more public buy‐in so people will be more invested in making certain that such information is not arbitrarily dismissed or drowned out by conspiracy theories. Such an approach may have the added the benefit of creating stronger collaborative connections between government, individual citizens, and civic organizations to promote overall resilience. More community involvement in terms of the collection and dissemination of information can provide value in terms of preparation for a public health emergency by bolstering surveillance efforts to detect a threat early on. Getting the public more integrated into the public health information system can also be valuable in terms of diminishing the threat of mis/disinformation. Building up relationships between the public and the public health sector can advance the mission of improving community resilience through education, engagement, and collaboration. In this review, we will examine existing evidence for this approach and will then conclude with possible new approaches.

This article studies the joint effects of issue salience and party strength on health-care expansion efforts in the American states. We contend that Democrats and Republicans fall back on their traditional policy stances when an issue is highly salient, but when it is less so, policy makers move to the more politically practical policy alternatives. We find that when health care is highly salient, Democrat-controlled states will be more likely to support direct coverage programs, while a Republican-controlled state will be more likely to support tax incentives. During periods of low-issue salience, policy makers are more open to pursuing options less consonant with traditional partisan policy preferences to make progress on the issue. This important contribution to the literature indicates that the level of attention an issue receives can not only affect whether effort is made to address the problem, but the substance of the policy too. abstract Este artículo estudia los efectos conjuntos de la relevancia de un problema y la fuerza de un partido respecto a los esfuerzos de expansión de la cobertura médica en los estados de la unión americana. Nosotros argumentamos que Demócratas y Republicanos mantienen sus posturas políticas tradicionales cuando un problema es altamente relevante, de lo

Currently there are over 45 million Americans without health insurance. Recent growth in Medicaid and State Children's Health Insurance Program (SCHIP) enrollment of children has filled in the sizable gap created by decreased employer‐sponsored insurance since 2000. While the share of children who are uninsured actually decreased between 2000 and 2003, little progress was made in expanding public insurance to adults. As a result, advocates and policymakers at the federal and state level are searching for approaches to deal with the growing number of the uninsured. Conservatives advocate encouraging individuals to buy private insurance while liberals advocate the provision of health coverage through publicly financed health care. Using a 50‐state multilevel individual growth model, this study estimates the net effect of two state approaches in terms of reducing the uninsured: tax incentives (the conservative approach) and direct‐coverage programs (the liberal approach). The results suggest that these approaches have not achieved the results that many advocates had suggested. In the case of tax incentives, the results suggest that states with tax incentives experience increases in the rate of the uninsured. In the case of direct‐coverage programs, results suggest that states receive no relief in the number of uninsured individuals. Finally, the analysis suggests that the efforts originating at the federal level are most successful. These programs are a continuation of the incremental approach policymakers in America have taken to address the problem of the uninsured, rather than taking steps toward a truly comprehensive solution.

The Energy and Commerce Committee in the U.S. House of Representatives developed the 21st Century Cures Act through a factfinding process that involved many different stakeholders in the biotechnology field. This effort can be viewed as an example of policy entrepreneurship in that the committee was trying to accelerate the development of new drugs and treatments. Some members of the committee were very active in this process, while others were less engaged. This article investigates what factors influenced individual legislators participation level in the initiative. We consider whether there is evidence that legislator characteristics and the types of groups actively involved in the initiative contributed to some important viewpoints going unaddressed. The evidence supports a contention in the literature that legislators approach biotechnology with a promotional focus as opposed to placing an emphasis on protecting the public from harm, which may have led to potentially problematic changes in areas such as informed consent.Acknowledgements: The authors wish to thank