plans are developed, a political decision is made on reform initiatives, those reforms are then
implemented, and their consequences are evaluated. The cycle then begins again, as new
problems arise that must be addressed by policymakers. (Figure 2.1)
Of course, in the real world, reform rarely takes place in such a simple fashion.
Instead, reform efforts may begin in different places and skip stages, or several stages may
occur at the same time. For example, health reformers might begin with a diagnosis…
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