THE NEW POLITICS OF US HEALTH-POLICY

Citation
Js. Hacker et T. Skocpol, THE NEW POLITICS OF US HEALTH-POLICY, Journal of health politics, policy and law, 22(2), 1997, pp. 315-338
Citations number
42
Categorie Soggetti
Medicine, Legal","Heath Policy & Services","Social Issues
ISSN journal
03616878
Volume
22
Issue
2
Year of publication
1997
Pages
315 - 338
Database
ISI
SICI code
0361-6878(1997)22:2<315:TNPOUH>2.0.ZU;2-7
Abstract
Following the demise of comprehensive health care reform in 1994, some reformers are seeking comfort in the successful ''incremental'' strat egy for enacting Medicare that emerged out of President Harry 'Truman' s failed campaign for national health insurance in 1948-50. But despit e similarities between the Truman and Clinton health security efforts, overall contexts of government and politics are much less hospitable to governmentally funded reforms today han they were after Truman's de feat. Back then, market transformations and political dynamics were bo th pushing toward expanded access to health services and insurance cov erage. Today, by contrast, both push in the opposite direction. The pr ivate insurance market is fragmenting, federal budgetary constraints s tymie new programs, and the deficit dominates debate over existing pro grams. Equally important, a stable pro-reform coalition like that of T ruman's day has yet to emerge, while a new and fiercely conservative c orps of Republicans is championing coherent programmatic alternatives based on antigovernment premises. Although passage of the Kassebaum-Ke nnedy health insurance reform bill in 1996 unleashed a wave of enthusi asm about incremental health care reform, formidable political, fiscal , and technical obstacles continue to stand in the way of even relativ ely modest incremental solutions.