With the collapse of national health care reform efforts in the
early 1990s, states emerged as a focal point for new policy and
administrative developments in U.S. health care. This book provides
a timely overview of the key issues facing states as they have
responded to this challenge. It tells how states are making
decisions about health policies and then putting them into
action-and how legislatures, executives, courts, and bureaucracies
all participate in this process.
"The New Politics of State Health Policy" describes many of the
major trends in states' responses to health care problems of the
1990s, and it identifies the forces that will influence state
policy actions in the new century. It examines reforms now under
way, from Medicaid to tobacco control to mental health, and
addresses today's most pressing issues surrounding managed care,
health insurance, and public health administration.
Editors Hackey and Rochefort have brought together a
distinguished group of scholars and practitioners in the field of
health policy analysis. Frank Thompson, Theodore Marmor, Michael
Dukakis, and others map out the different institutional frames
shaping how each state approaches the health care domain. While
some states deliberate over universal coverage, others have shifted
to the county level decisions once made in Washington, D.C. But all
face the difficulty of taking on unprecedented responsibilities
with limited resources amid the often-conflicting concerns of
public management and "moral politics."
Each contribution in the volume explores the interplay between
state governance and health care policy by addressing four themes:
the capacity of states to fulfill their new health care roles, the
significance of recent policy changes, patterns in the politics of
state health policy making, and the relationship of state-level
changes to failed national health care reform. Together, they sound
the call for stronger partnerships with both federal agencies and
private sector organizations and the need for state officials to
engage in broader, "outside-the-box" thinking.
As these essays show, health care policy can only be as good as
the governments that make it. "The New Politics of State Health
Policy" can help scholars, researchers, and practitioners better
assess the programs and policy process in their own states in order
to meet the demands of the health care marketplace on the one hand
and public expectations on the other.
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