Evaluating the National Health Planning and Resources Development Act: learning from experience?

The future of health planning and regulation is tied to past performance in both a political and intellectual sense. Evidence of success or failure to accomplish program goals will structure partisan debate about the future of PL 93-641; and the experience of the past seven years will provide policy analysts with the raw material from which to build more effective technologies of planning and regulation. This paper discusses a number of analytic factors which jeopardize the integrity of both impact assessment and knowledge development. These include the nature of the program's goals, the difficulties of generating reliable forecasts as to what would have occurred in the program's absence, the likelihood of unintended consequences, and the seeming inevitability of having to work with elaborate multivariate models which contain numerous interaction terms. We argue that without careful analysis and cautious interpretation, grand experiments such as PL 93-641 are likely to yield little useful evidence to guide policy adaptation.