This is a study of a legislative conflict over the National Health Insurance policy played out in the 96th Congress of the United States. It attempted to find out whether the policy aimed at restructuring the U.S. health care system was possible. Since previous analysis concluded that the Kennedy NH1 plan was such an innovative policy the questions examined here were: (1) Would the Kennedy plan emerge as the adopted national policy? (2) If not, what plan could be a compromise proposal?
To answer the first question the forward process of planning was applied. The conflict was structured according to the levels of a conceptual hierarchy. The focus of the hierarchy constituted the first level, the actors involved the second, their objectives and subobjectives formed the third and fourth levels, and the policies pursued by the actors (the NH1 proposals) the fifth level. The elements of each level were weighed according to their relative importance by using the principal eigenvectors of a series of pairwise comparison matrices. The priority of the NH1 plans promoted by the particular groups was derived on the assumption that a plan with the highest eigenvector will probably emerge as the adopted national health policy. The forward process answered the question: Given the present actors, their objectives, and the strength to influence the outcome, which NH1 plan was the most likely to emerge as the adopted national policy?
To answer the second question the backward process of planning was applied. It was an attempt to find a compromise solution acceptable to all the parties involved.
This method of policy design, developed by Thomas L. Saaty, has great advantages over the traditional methods of policy planning. It brings into focus the matrix of competing interests and sets firm boundaries for planning efforts. It helps in setting pragmatic, not romantic policies, with a great saving of time and money.