Public Forum

A Cuban Experience
Having just recently returned from a trip to Cuba, I read the articles on Cuba [December 2003 Footnotes, p. 8] with great interest. I was particularly struck by comments in Mercedes Rubio’s piece, “Learning from the Cuban Health Care Paradox,” since I personally experienced the Cuban health care system during my visit. Having traveled to Cuba under an educational/academic visa, I was with an Elderhostel group during December 10-29, 2003.

During the trip, I caught a cold, which worsened to bronchitis. On the fourth day, the tour leader came to me to tell me she noticed I did not look well, and she wanted to have a physician see me there in Havana, before the bus would leave the next day for Santa Clara and on to Trinidad. She took me to a woman physician who insisted that I stay at a hospital for a few days. At the prospect of missing a visit to one of Cuba’s oldest and most interesting cities, Trinidad, I was very reluctant to agree to visit the hospital instead.

Unfortunately, I had to give in, but, as a result, I experienced the Cuban medical system, which was very good, in my opinion. Admittedly, while I was in a small hospital reserved only for foreigners, I was given a private room with bath and received excellent care.

In the early afternoon of the fifth day, I was discharged from the Clinica Central Cira Garcia—where only Spanish had been spoken—and was escorted back to the hotel by taxi by a bilingual person. There, I rejoined the group and flew home with them. I’ll be happy to recount more details to interested readers.

Hannah R. Wartenberg, retired and long-time ASA member (hwartenb@aol.com), New York, NY

Public Action and Public Policy
Footnotes’ new “Public Sociology” column defines public action as “projects that engage sociology in the civic arena in service to organizations and communities.” Public action can also contribute to public policy, although I argue below that sociologists should avoid public policymaking itself. I see at least five ways in which sociological public action can be useful to public policy.

1. Empirical research. Our most important contribution is still what ASA President Michael Burawoy calls professional sociology, particularly when it is empirical research conducted among populations and in institutions for which policy may be made. Policy experts often hold inaccurate assumptions about how populations behave and institutions function, as well as how they relate to the larger society. Ethnographic and other qualitative research is most likely to reach the policy experts, but economic research and quantitative studies help correct outdated assumptions as well.

2. Policy Implications. Researchers can assist public policy by discussing policy implications of their research findings. For example, they could suggest reforms that would ameliorate problems their research identified. Diane Vaughan’s October 2003 Public Sociology column detailed organizational failures in NASA and suggested corrections that might prevent future space shuttle disasters.

3. Policy Consequences. Sociologists can also make direct contributions to policy analysis by reviewing proposed policies and indicating likely consequences, positive as well as negative.

Policy experts generally know the formal structures that operate in the institutions for which they develop policy, but sociologists know the informal ones that may determine whether such policies will actually work. Policy analysts also see the social structure top down, while sociologists especially those who have done fieldwork, typically see it from the bottom up and understand what happens to policies handed down from the top.

Policy experts can generally assess the economic consequences of their policy ideas and elected officials will take care of the political ones, but sociologists know the social ones—of proponents and opponents—that can facilitate or frustrate the experts’ objectives.

4. Policy Critiques. Sociologists can use research experience and specialized knowledge to criticize public policy. Whether and when they have the requisite knowledge to criticize proposed or existing policies as sociologists has been disputed within ASA, most recently over the Iraq war, but that dispute had as much to do with ASA’s mandate as with the adequacy of sociological knowledge.

When the policy is less controversial, sociological knowledge is usually judged less harshly. As a result, sociologists often act as expert witnesses, offer testimony before public officials, and act as pro bono advisers to citizen groups or social movements organizations.

Moreover, sociologists are always free to be policy critics and even policymakers as citizens (e.g., proposing new housing or disarmament policies). Provided they have the research experience or knowledge, they can speak in both roles concurrently.

5. Representing the “Voiceless.” Because of their ability to identify those affected by public policies (3. above), sociologists are in an especially good position to speak for the people who are not visible to policy experts. They can also do so for people who lack the political voice to make their views known.

Having for generations studied victims and underdogs, sociologists may in fact be uniquely able to present the needs and rights of the voiceless. I would even argue that sociologists have an obligation to speak for the voiceless, if they have the requisite expertise.

Against Public Policymaking

Public action, even when it contributes to public policy, is not the same as public policymaking. The latter is an applied social science and political art and involves analyzing existing and proposed public policies, framing specific policies and programs, drafting legislation, developing budgets and other implementation mechanisms to achieve public purposes. Well-intentioned sociologists sometimes believe they can make public policy just because they are social scientists, but most are not equipped to do so. Sociologists can study how people build and use housing, but they are not thereby qualified to make housing policy.

The shortcomings of sociologists with respect to public policymaking are exemplified in recommendations frequently attached to research articles. Sometimes they fit nicely into one of the five public action categories above, but they can also be maddeningly general. Sociologists are good at proposing structural transformation, cultural change, and the elimination of social evils. However, this is rhetoric, not policy, and likely will not persuade policymakers or politicians. But there are other reasons for sociologists to keep their distance from policymaking. Policy expertise requires distinctive training and/or experience that have little to do with sociology. These include multidisciplinary ways of thinking in order to frame policy, economic and other analyses, and benefit-cost analyses. Furthermore, sociologists have not been trained to operate in a discipline embedded in national and local politics. Embedding may not be the right term, but whatever policy analysts do and recommend, in the end the important policy decisions are made by elected officials. This is as it should be in a democracy, and sometimes officials also follow staff recommendations. However, officials sometimes use their policymaking power to pursue their own political goals (e.g., re-election), and then the needs of their constituents may be trumped by the demands of the power holders that broker elections. Headlines tell us how much national policy responds to campaign funders rather than to voters.

Some sociologists are likely uncomfortable with the contemporary field of policy analysis because of its economic biases, lack of sociological imagination, loyalty to conventional wisdom, as well as its role in helping establishments stay in power. For better or worse, most sociologists are not equipped to function in this context, or at least not until they obtain training in public policymaking—and then fix some of its faults!