This book represents the first comparative study of how health policy is made in leading industrial nations. Using detailed case histories of the UK, the US and Germany, it shows that health care systems and modern states are indissolubly bound together. The author explains how the health care state originated before the rise of democracy, and demonstrates that it has had to confront the twin pressures of democratic politics and competitive capitalism. It focuses on three important arenas of health care politics--the government of consumption, the government of doctors, and the government of medical technology--and illustrates how these three arenas intersect.

Drawing on compelling current examples, Governing Health is a timely and essential book.

The contentious passage of the Affordable Care Act in 2010 highlighted the incredible complexity and controversy surrounding health care in the United States. While the U.S. federal government does not provide universal health care, it has an extremely wide reach when it comes to the health of its citizenry. From important scientific and medical research funding to infectious disease control and health services for veterans and the elderly, the pathway to legislation and execution of health policies is filled with competing interests and highly varied solutions. The Guide to U.S. Health and Health Care Policy provides the analytical connections showing researchers how issues and actions are translated into public policies and institutions for resolving or managing healthcare issues and crises. The Guide highlights the decision-making cycle that requires the cooperation of federal and state governments, business, and an informed citizenry in order to achieve a comprehensive approach to advancing the nation’s healthcare policies. Through 30 topical chapters, the book addresses the development of the U.S. healthcare system and policies, the federal agencies and public and private organizations that frame and administer those policies, and the challenges of balancing the nation’s healthcare needs with the rising costs of medical research, cost-effective treatment, and adequate health insurance. Additionally, the book comprehensively addresses significant disparities that exist in the U.S. system and the challenges to public health posed by our increasingly connected world. Taking a comprehensive approach, the Guide traces policy initiatives across time and takes into account the most recent scholarship: Part One: Evolution of American Health Care Policy Looks at the emerging and expanding role of government in the health care sector and the position the U.S. occupies today as the only advanced industrial nation without universal health care. Part Two: Government Organizations that Develop, Fund, and Administer Health Policy (1789-Today) Examines the role each branch of government plays in the forming, executing, and regulating health care policies. The authors examine the origins, organization, budget, and function of major government organizations including the FDA, CDC, and VA. An exploration of legal oversight and the roles states play in the health sector round out this section. Part Three: Contemporary Health Policy Issues: Goals and Initiatives (1920s-Today) Explores the wide range of players in the health care sphere and the role the government plays, particularly in funding them. Special attention is paid to policy issues surrounding medical research and medical professions. This section also looks at the ethical issues in play when making health policy and the inequalities that have plagued the U.S. health care system. Part Four: Contemporary Health Policy Issues: People and Policies (1960s-Today) This part of the book looks in-depth at health disparities in the U.S., health challenges particular to specific groups, mental health, obesity, and the influence of interest groups. Part Five: U.S. Response to Global Health Challenges (1980s-Today) The last section of the book looks beyond the borders of the United States and the serious challenges posed by our increasingly connected world.

This book examines the role of government in developing the system of health services in the U.S. mainly during the years 1930 through 1980. It traces the building of this system during this critical period within the framework of the overarching economic, social, and political policies adopted by American governments. The author's range of coverage is extremely broad, from "public health" through medical care, health manpower, health facilities, national development of local health planning, and regulation of private services. Medicare care and the special circumstances that led to the failure to establish a system of universal and comprehensive medical care coverage--an outcome unique among the developed democracies of the world--are emphasized. Environmental health protection and health education are treated in considerable detail, and again the particular paths followed in their development are shown to reflect the ways in which American society as a whole has evolved. The book contributes to an understanding of what actually happened in the 50 developmental years in contrast to widely accepted notions about the inexorable outcome of government health service programs based on some strongly arguable theoretical formulations. Although the primary emphasis is on social policy analysis, the descriptive treatment of health service structures is sufficiently detailed so that the book can serve as a text and reference on health services practice and organization. No other volume of comparable scope and depth is available, and this book is also unique in the degree to which it embeds health services policy analysis in the theory and practice of the social welfare state.

States are increasingly important players in the current efforts to reform U.S. health care, as the federal government withdraws from this responsibility. Robert B. Hackey analyzes the varied routes states have taken in reformulating health care policy and provides a road map of what specific strategies work and why. In this comparative case study, Hackey focuses on four states -- Massachusetts, New Hampshire, New York and Rhode Island -- that have had markedly different experiences with regulating health care over the past two decades. Hackey's detailed comparisons show how the states' policies changed over time, moving from regulatory to market-oriented solutions, and examines which policy programs appear best poised to meet the future. Hackey uses regime theory to explain how the states' policy choices concerning cost control and entry regulation were shaped by the prevailing political culture and institutions of each state. He concludes that the autonomy of state government from special interests is vital to the successful adoption, implementation and outcome of state initiatives. Rethinking Health Care Policy offers policymakers, planners and specialists useful insights into the politics of state regulation and into future directions for health care reform.

Governing Health examines health care policy making from a long-term, political perspective, describing how Congress, the president, special interest groups, bureaucracy, and state governments help define health policy problems and find politically feasible solutions. The third edition of this pathbreaking book is updated to cover recent legislative efforts, including the Medicare prescription drug benefit. Praise for previous editions of Governing Health