Interest Groups and Health Care Reform Across the United States

Interest Groups and Health Care Reform Across the United States

Virginia Gray
David Lowery
Jennifer K. Benz
Copyright Date: 2013
Pages: 248
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  • Book Info
    Interest Groups and Health Care Reform Across the United States
    Book Description:

    Universal health care was on the national political agenda for nearly a hundred years until a comprehensive (but not universal) health care reform bill supported by President Obama passed in 2010. The most common explanation for the failure of past reform efforts is that special interests were continually able to block reform by lobbying lawmakers. Yet, beginning in the 1970s, accelerating with the failure of the Clinton health care plan, and continuing through the passage of the Affordable Care Act in 2010, health policy reform was alive and well at the state level. Interest Groups and Health Care Reform across the United States assesses the impact of interest groups to determine if collectively they are capable of shaping policy in their own interests or whether they influence policy only at the margins. What can this tell us about the true power of interest groups in this policy arena? The fact that state governments took action in health policy in spite of opposing interests, where the national government could not, offers a compelling puzzle that will be of special interest to scholars and students of public policy, health policy, and state politics.

    eISBN: 978-1-58901-990-4
    Subjects: Political Science, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Tables and Figures
    (pp. ix-x)
    (pp. xi-xii)
  5. INTRODUCTION: Interests and Health Policy
    (pp. 1-4)

    This book is about the politics of interest representation. It is also about health care policy and politics in the American states. But it is first and foremost a book about interest representation. Simply put, there is a deep and profound debate among both academics and citizens about the role interest organizations play in the public policy process (Lowery and Gray 2004b). On the one hand, the press routinely recycles stories of undue influence of narrow, selfish special interest groups, highlighting their privileged position in American politics. In academic discussions, this view is sometimes labeled the transactions perspective because it...

  6. CHAPTER 1 Health Care and Organized Interests in the United States
    (pp. 5-40)

    Universal health care coverage was on the national political agenda for nearly a hundred years, from the platform of Teddy Roosevelt’s Bull Moose Party in 1912, to President Franklin Roosevelt’s consideration in the 1930s, to the long string of presidents who introduced major reform bills to expand access—starting with Harry Truman in the 1940s, to Lyndon Johnson, who got Medicare and Medicaid adopted in 1965; continuing with Richard Nixon, who introduced a universal coverage plan subsequently endorsed by Gerald Ford; and to Bill Clinton, whose universal coverage plan based on managed competition failed in 1994. None of their proposals...

  7. CHAPTER 2 The Theory and Structure of Health Interest Communities in the States
    (pp. 41-59)

    Politicians, media commentators, and scholars alike long have been concerned about the role of organized interests in public policy. Of particular concern is the seeming dominance of business over citizens and not-for-profit groups. In spite of this concern about the balance of different types of interest organizations in the population as a whole, the conversation in much of the media is about individual interest organizations. How is a given firm or association mobilized? What actions has it undertaken to influence public officials? And how influential is it? But there are limits to what we can learn by looking at one...

  8. CHAPTER 3 State Pharmacy Assistance Programs as Innovations
    (pp. 60-92)

    At the end of 2003 President George W. Bush and the Republican Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA), the largest increase in social spending since the Great Society, which was estimated to cost at least $400 billion over ten years. The law began as an effort to add prescription drug coverage to Medicare, a problem that had been recognized for the previous thirty-eight years, and an issue highlighted by President Bill Clinton in his State of the Union Address in 1999. The Clinton administration and Democrats in Congress, blessed with a budgetary surplus, had attempted...

  9. CHAPTER 4 The Politics of Managing Managed Care
    (pp. 93-122)

    The rise and fall of managed care is one of the most significant stories associated with the politics of health care during the last fifty years. Managed care began from local efforts associated with rural cooperatives in the 1920s and expanded during World War II through the efforts of the industrialist Henry Kaiser. By the late 1960s it had become the preferred option of consumer advocates because of its emphasis on preventive care. At roughly the same time managed care became the preference of business because it controlled health care costs as compared with the existing fee-for-service system. This happy...

  10. CHAPTER 5 Universal Health Care in the States
    (pp. 123-159)

    During the 1990s the states and the federal government addressed many of the same health care issues—universal coverage, regulation of managed care, and prescription drug coverage for seniors. But, as we have seen, the outcome was often different, with health reforms being enacted later or not at all at the federal level. In chapter 3 we saw that by 2004, thirty-four states had passed some kind of pharmaceutical assistance law, using state funds to pay for a portion of the cost of drugs for eligible senior residents. In chapter 4 we learned that between 1994 and 2001, the fifty...

  11. CHAPTER 6 Conclusion: Lessons Learned and Opportunities for Influence in the ACA Policy Environment
    (pp. 160-178)

    In this final chapter we summarize our key findings about the role of interest groups in state health reform, comparing the three different reforms we have highlighted in this book. As noted in the introduction, this book is primarily one about the influence of organized interests with secondary emphases, albeit vital to a research design capable of addressing the first issue, on health policy and state policymaking. Thus, our conclusions bear on all three of these topics. In looking at the specific results, we first discuss the findings in terms of the innovation theory framework used throughout the book. Second,...

  12. Appendix 2.1: Descriptions of Health Interest Organization Subguilds
    (pp. 179-182)
  13. Appendix 2.2: States Ranked by Health Interest Group Density
    (pp. 183-184)
  14. Appendix 2.3: Density by Subguild, Raw Numbers in 1998
    (pp. 185-186)
  15. Appendix 2.4: Data Source for Political Action Committees
    (pp. 187-188)
  16. Appendix 3.1: List of Data Sources
    (pp. 189-191)
  17. Appendix 3.2: Estimation of Annual Interest Group Measures Using the ESA Model
    (pp. 192-193)
  18. Appendix 4.1: Data Sources of Dependent Variables
    (pp. 194-195)
  19. Appendix 4.2: Managed Care Regulation Descriptive Statistics
    (pp. 196-197)
  20. Appendix 4.3: Definitions and Sources of Independent Variables
    (pp. 198-199)
  21. Appendix 5.1: Sources of Dependent Variables
    (pp. 200-201)
  22. Appendix 5.2: Sources of Independent Variables
    (pp. 202-206)
  23. References
    (pp. 207-226)
  24. INDEX
    (pp. 227-236)