Learning Lessons: Medicine, Economics, and Public Policy

This is a book about the policy process. It discusses the considerations advisers have in mind as they develop and select policy alternatives, the ways each of us might want to think about making decisions, and the lessons we should remember in order to minimize avoidable errors. In writing about his experiences in government, the classroom, and private life, Fein offers insights that apply to people responsible for decisions in many kinds of institutions, at all levels of responsibility. His anecdotes and the situations he describes are drawn from over fifty years of experience in the policy arena. They are not intended to represent either a rounded theory about public administration or a comprehensive treatment of important components of political science. Like most people in the policy arena, Fein came to that work from another discipline-in his case economics. His experience of "finding his own way" through action and experience rather than through application of theory might appear quaint. But his successes, failures, and the lessons he learned, illuminate the process and may prove useful, even inspirational. Fein is sensitive to the need to move beyond statistics and to present the real world and the faces of real people behind the data. He believes that an effective adviser should bring knowledge and interests that extend beyond the confines of a single discipline, even one as methodologically powerful as economics. Unless the adviser presents a range of choices that have been developed with contributions from many fields of knowledge, the proposed policies are likely to be far too constrained and, at worst, unworkable. His perspective, articulated in this book, is easily summarized: there is more to life and to our nation's welfare than economics. We live in a society, not in an economy.

Table of Contents:
AcknowledgmentsIntroduction1. The Time to Change the Rules is Before the Game Begins2. The Meaning and Infl uence of WordsWords, Attitudes, and BehaviorThe Impact of Unexpected LanguageSame Words, but Different MeaningsContext MattersPhysicians and Social Scientists: A ContrastThere's Rationing and There's Rationing3. Defining the Policy Options and IssuesShould Politics Affect Policy?Asking the Correct QuestionSome Changes Take TimeIs Everything Connected?4. Knowing the OtherLearning from the Non-ExpertExperience CountsWe All Play Many RolesComments that Increase Our Understanding5. Four LessonsThe Known Drives Out the AbstractNot Everyone Thinks Like an EconomistPolitics Trumps Rational EconomicsKeep It SimpleEpilogueOne Person Can Make a DifferenceNotesIndex