Policy Feedback and Long-Term Care Policy in Poland

Drawing on policy feedback theory, the planned paper will focus on long-term residential care (LTC) within Poland's healthcare system. It presents a hypothesis explaining why essential policy instruments—such as regulating the quality of care or publicly reporting quality performance—have not yet been introduced, despite their proven potential to improve LTC in many other countries. It is argued that this occurred due to powerful path-dependent processes within this policy, resulting in a strong status quo. Self-reinforcing feedback mechanisms have dominated, with few feedback loops capable of initiating path-breaking or path-departing changes. The paper is based on analysing the five feedback mechanisms as endogenous factors present in the LTC policy and two selected exogenous factors that influence them and ultimately affect the design of LTC policies. The first reinforces feedback mechanisms related to state capacity, resulting in greater difficulties for LTC policy in employing effective policy tools. The second reinforces feedback mechanisms related to power asymmetries, leading policy actors to adopt a more adversarial approach when shaping long-term care policy outcomes.