Debra L. Dodson
- Published in print:
- 2006
- Published Online:
- May 2006
- ISBN:
- 9780198296744
- eISBN:
- 9780191603709
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0198296746.003.0013
- Subject:
- Political Science, Comparative Politics
The story of health insurance reform in the 104th brings to life many of the contested issues surrounding gender difference in impact. It illustrates the importance of going beyond quantitative ...
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The story of health insurance reform in the 104th brings to life many of the contested issues surrounding gender difference in impact. It illustrates the importance of going beyond quantitative evidence of gender difference to look carefully at the substance of those differences that emerge, to understand their relationship to the broader political context, and to explicitly consider the motivations belying difference. That those who were seen as advocates for women in the health care reform battles of the 103rd played little role in health insurance reform, while some of the more visible vocal women critics of the Clinton plan led the effort some saw as ‘radical’, that the prime [female] motivator and facilitator of the effort was not seen as driven by gendered forces or even connected with women’s organizations, and that Republican women who had supported women’s health also supported a measure likely to have reversed state mandates protecting women’s health benefits all make health insurance reform a unique laboratory for addressing the contested issues that surround difference. The conclusions suggest a growing gap between gender difference and the standards of third wave feminism, the need for an active engaged women’s movement to counter the threat posed by essentialist assumptions that grant legitimacy to any pronouncement women make on behalf of women, the contribution differences in the masculinist cultures of parties may make toward partisan differences in the manifestation of feminist protest, and they caution against the gendered consequences of ostensibly gender-neutral institutional procedures.Less
The story of health insurance reform in the 104th brings to life many of the contested issues surrounding gender difference in impact. It illustrates the importance of going beyond quantitative evidence of gender difference to look carefully at the substance of those differences that emerge, to understand their relationship to the broader political context, and to explicitly consider the motivations belying difference. That those who were seen as advocates for women in the health care reform battles of the 103rd played little role in health insurance reform, while some of the more visible vocal women critics of the Clinton plan led the effort some saw as ‘radical’, that the prime [female] motivator and facilitator of the effort was not seen as driven by gendered forces or even connected with women’s organizations, and that Republican women who had supported women’s health also supported a measure likely to have reversed state mandates protecting women’s health benefits all make health insurance reform a unique laboratory for addressing the contested issues that surround difference. The conclusions suggest a growing gap between gender difference and the standards of third wave feminism, the need for an active engaged women’s movement to counter the threat posed by essentialist assumptions that grant legitimacy to any pronouncement women make on behalf of women, the contribution differences in the masculinist cultures of parties may make toward partisan differences in the manifestation of feminist protest, and they caution against the gendered consequences of ostensibly gender-neutral institutional procedures.
Jonathan Morduch
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780195305197
- eISBN:
- 9780199783519
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195305191.003.0022
- Subject:
- Economics and Finance, Development, Growth, and Environmental
This essay focuses on the design of insurance products for poor customers. Several promising innovations are described: credit life insurance, health insurance partnerships, and weather insurance. ...
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This essay focuses on the design of insurance products for poor customers. Several promising innovations are described: credit life insurance, health insurance partnerships, and weather insurance. Each was created to serve populations that were previously unserved, and workable institutional solutions are emerging. The next step must be to shift from the question of what creates workable institutions to the question of how to refine designs to best serve low-income populations. In doing so, current approaches must be reassessed in order to most improve clients’ lives and to avoid doing unintended harm.Less
This essay focuses on the design of insurance products for poor customers. Several promising innovations are described: credit life insurance, health insurance partnerships, and weather insurance. Each was created to serve populations that were previously unserved, and workable institutional solutions are emerging. The next step must be to shift from the question of what creates workable institutions to the question of how to refine designs to best serve low-income populations. In doing so, current approaches must be reassessed in order to most improve clients’ lives and to avoid doing unintended harm.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0008
- Subject:
- Sociology, Race and Ethnicity
This chapter demonstrates how the coalition of insurance companies, managed-care firms, and small businesses destroyed a proposal for home care for disabled people in the 1980s, and notes that the ...
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This chapter demonstrates how the coalition of insurance companies, managed-care firms, and small businesses destroyed a proposal for home care for disabled people in the 1980s, and notes that the same coalition also attacked President Clinton's plan for universal health care in the 1990s. It begins by discussing long-term care for the weak elderly, then looks at another revival of the national health insurance and introduces the Consolidated Omnibus Reconciliation Act of 1985, which tried to fill the gaps within the private health insurance system. The chapter then studies health policy making after the Health Security failed.Less
This chapter demonstrates how the coalition of insurance companies, managed-care firms, and small businesses destroyed a proposal for home care for disabled people in the 1980s, and notes that the same coalition also attacked President Clinton's plan for universal health care in the 1990s. It begins by discussing long-term care for the weak elderly, then looks at another revival of the national health insurance and introduces the Consolidated Omnibus Reconciliation Act of 1985, which tried to fill the gaps within the private health insurance system. The chapter then studies health policy making after the Health Security failed.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0002
- Subject:
- Sociology, Race and Ethnicity
This chapter looks at how the physicians mobilized against the proposals for government health insurance. This period of mobilization was from the Progressive Era to the 1950s. The chapter starts ...
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This chapter looks at how the physicians mobilized against the proposals for government health insurance. This period of mobilization was from the Progressive Era to the 1950s. The chapter starts with a study of the campaign for compulsory health insurance, which was introduced during the Progressive Era and revived in 1929. It then examines the national health insurance during the postwar era and the conflict between the national health insurance campaign of the Truman administration and the Medical Lobby. The chapter also discusses the available subsidy for insurers.Less
This chapter looks at how the physicians mobilized against the proposals for government health insurance. This period of mobilization was from the Progressive Era to the 1950s. The chapter starts with a study of the campaign for compulsory health insurance, which was introduced during the Progressive Era and revived in 1929. It then examines the national health insurance during the postwar era and the conflict between the national health insurance campaign of the Truman administration and the Medical Lobby. The chapter also discusses the available subsidy for insurers.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0006
- Subject:
- Sociology, Race and Ethnicity
This chapter examines the 10-year struggle of federal officials to introduce the measures of cost containment, discussing the effect this struggle had on the hope of national health insurance and ...
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This chapter examines the 10-year struggle of federal officials to introduce the measures of cost containment, discussing the effect this struggle had on the hope of national health insurance and looking at the revival of national health insurance, which began in 1968. Next, it looks at Jimmy Carter's role in the hospital industry, noting that Carter initially ignored health care during the first months of his presidential campaign, and then studies the “staging” of universal coverage and introduces the prospective payment system.Less
This chapter examines the 10-year struggle of federal officials to introduce the measures of cost containment, discussing the effect this struggle had on the hope of national health insurance and looking at the revival of national health insurance, which began in 1968. Next, it looks at Jimmy Carter's role in the hospital industry, noting that Carter initially ignored health care during the first months of his presidential campaign, and then studies the “staging” of universal coverage and introduces the prospective payment system.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.001.0001
- Subject:
- Sociology, Race and Ethnicity
Every industrial nation in the world guarantees its citizens access to essential health care services—every country, that is, except the United States. In fact, one in eight Americans—43 million ...
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Every industrial nation in the world guarantees its citizens access to essential health care services—every country, that is, except the United States. In fact, one in eight Americans—43 million people—do not have any health care insurance at all. This book offers a history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, it shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. The author describes how, at first, physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized “grassroots” protests, conspiring with other like-minded groups to defeat reform efforts. As the success of Medicare and Medicaid in the mid-century led physicians and the AMA to start scaling back their attacks, the insurance industry began assuming a leading role against reform that continues to this day.Less
Every industrial nation in the world guarantees its citizens access to essential health care services—every country, that is, except the United States. In fact, one in eight Americans—43 million people—do not have any health care insurance at all. This book offers a history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, it shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. The author describes how, at first, physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized “grassroots” protests, conspiring with other like-minded groups to defeat reform efforts. As the success of Medicare and Medicaid in the mid-century led physicians and the AMA to start scaling back their attacks, the insurance industry began assuming a leading role against reform that continues to this day.
George Wagoner, Anna Rappaport, Brian Fuller, and Frank Yeager
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780199204656
- eISBN:
- 9780191603822
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0199204659.003.0008
- Subject:
- Economics and Finance, Financial Economics
The increase in both retiree medical care expenditures and the retired fraction of the population has put pressure on retiree health care insurance providers. This chapter assesses future prospects ...
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The increase in both retiree medical care expenditures and the retired fraction of the population has put pressure on retiree health care insurance providers. This chapter assesses future prospects for retiree health insurance, focusing on traditional approaches to retiree health benefits where the employer assumes most risk, and on defined contribution approaches where significant risk is shifted to the retiree. It also examines government benefits for retirees, including new Medicare prescription drug benefits. It models future retiree health care costs and opportunities to save before retiring, highlighting public policy obstacles and issues for employer-provided retiree health benefits.Less
The increase in both retiree medical care expenditures and the retired fraction of the population has put pressure on retiree health care insurance providers. This chapter assesses future prospects for retiree health insurance, focusing on traditional approaches to retiree health benefits where the employer assumes most risk, and on defined contribution approaches where significant risk is shifted to the retiree. It also examines government benefits for retirees, including new Medicare prescription drug benefits. It models future retiree health care costs and opportunities to save before retiring, highlighting public policy obstacles and issues for employer-provided retiree health benefits.
Barak Richman, Daniel Grossman, and Frank Sloan
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195390131
- eISBN:
- 9780199775934
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195390131.003.012
- Subject:
- Law, Medical Law
This chapter discusses consumption disparities in outpatient mental health services among a diverse insured working population. It first observes that despite paying equal insurance premiums and ...
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This chapter discusses consumption disparities in outpatient mental health services among a diverse insured working population. It first observes that despite paying equal insurance premiums and enjoying equal insurance coverage, lower-income and non-white workers consume fewer insurance benefits than their white and higher-income coworkers. It finds no evidence, however, that this disparity leads to adverse health outcomes. It additionally finds that non-whites and low-income individuals are more likely than their white and high-income counterparts to obtain mental health care from general practitioners rather than mental healthcare providers, and nearly twice as likely not to follow up with a mental health provider after hospitalization with a mental health diagnosis. These findings suggest that low-income and non-white individuals might be paying for health services that primarily benefit their white and more affluent coworkers. Many of these regressive consequences can be attributed to mental health insurance carve-outs, which are a product of the fragmented delivery of health care.Less
This chapter discusses consumption disparities in outpatient mental health services among a diverse insured working population. It first observes that despite paying equal insurance premiums and enjoying equal insurance coverage, lower-income and non-white workers consume fewer insurance benefits than their white and higher-income coworkers. It finds no evidence, however, that this disparity leads to adverse health outcomes. It additionally finds that non-whites and low-income individuals are more likely than their white and high-income counterparts to obtain mental health care from general practitioners rather than mental healthcare providers, and nearly twice as likely not to follow up with a mental health provider after hospitalization with a mental health diagnosis. These findings suggest that low-income and non-white individuals might be paying for health services that primarily benefit their white and more affluent coworkers. Many of these regressive consequences can be attributed to mental health insurance carve-outs, which are a product of the fragmented delivery of health care.
Jill Quadagno
- Published in print:
- 2006
- Published Online:
- May 2012
- ISBN:
- 9780195160390
- eISBN:
- 9780199944026
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195160390.003.0003
- Subject:
- Sociology, Race and Ethnicity
This chapter studies trade unions and how they helped promote the emerging private health insurance system, showing that the trade unions also led the drive for Medicare and disability insurance. It ...
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This chapter studies trade unions and how they helped promote the emerging private health insurance system, showing that the trade unions also led the drive for Medicare and disability insurance. It looks at the development of private health benefits and the events that led to the establishment of disability insurance and insurance for retirees. Finally, the chapter shows how those who supported medical insurance finally defeated the American Medical Association.Less
This chapter studies trade unions and how they helped promote the emerging private health insurance system, showing that the trade unions also led the drive for Medicare and disability insurance. It looks at the development of private health benefits and the events that led to the establishment of disability insurance and insurance for retirees. Finally, the chapter shows how those who supported medical insurance finally defeated the American Medical Association.
Henning Bohn
- Published in print:
- 2006
- Published Online:
- September 2006
- ISBN:
- 9780199204656
- eISBN:
- 9780191603822
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0199204659.003.0002
- Subject:
- Economics and Finance, Financial Economics
Retirement systems in the past have attempted to protect retirees from risk. However, by making fixed benefit promises, these systems necessarily imposed a more-than-proportional risk on younger ...
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Retirement systems in the past have attempted to protect retirees from risk. However, by making fixed benefit promises, these systems necessarily imposed a more-than-proportional risk on younger cohorts and on future generations. This chapter explores the impacts of alternative tax, pension, and health care policies to evaluate how current policies spread risk across cohorts. It also assesses conditions under which such policies increase general welfare, and where there may be scope for better policies.Less
Retirement systems in the past have attempted to protect retirees from risk. However, by making fixed benefit promises, these systems necessarily imposed a more-than-proportional risk on younger cohorts and on future generations. This chapter explores the impacts of alternative tax, pension, and health care policies to evaluate how current policies spread risk across cohorts. It also assesses conditions under which such policies increase general welfare, and where there may be scope for better policies.
Beatrix Hoffman
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780195388299
- eISBN:
- 9780199866519
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195388299.003.0003
- Subject:
- Political Science, American Politics
Hoffman examines the question of why the United States does not yet have universal health coverage for its citizens. Where past explanations have focused on the role of private interest groups, the ...
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Hoffman examines the question of why the United States does not yet have universal health coverage for its citizens. Where past explanations have focused on the role of private interest groups, the structure of government and previous policy decisions, and/or U.S. public opinion and political culture, Hoffman examines the lack of a major social movement in support of universal health care as an explanatory factor. Tracing the historical relationship between social movements (or the lack thereof) and major attempts to reform health care in the United States, Hoffman argues that an important reason for the failure of health reform throughout the twentieth century is that health reformers have relied primarily on elite expertise rather than popular support in their campaigns. Hoffman concludes that while presidential leadership will be a prerequisite for any major health care reform, leaders also need the support and inspiration from strong popular movements if they are to succeed in transforming the health care system.Less
Hoffman examines the question of why the United States does not yet have universal health coverage for its citizens. Where past explanations have focused on the role of private interest groups, the structure of government and previous policy decisions, and/or U.S. public opinion and political culture, Hoffman examines the lack of a major social movement in support of universal health care as an explanatory factor. Tracing the historical relationship between social movements (or the lack thereof) and major attempts to reform health care in the United States, Hoffman argues that an important reason for the failure of health reform throughout the twentieth century is that health reformers have relied primarily on elite expertise rather than popular support in their campaigns. Hoffman concludes that while presidential leadership will be a prerequisite for any major health care reform, leaders also need the support and inspiration from strong popular movements if they are to succeed in transforming the health care system.
Sylvia Guendelman and Kate Cosby
- Published in print:
- 2008
- Published Online:
- January 2009
- ISBN:
- 9780195310122
- eISBN:
- 9780199865284
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195310122.003.0009
- Subject:
- Social Work, Social Policy, Children and Families
For many of those among the working poor who lack coverage by medical insurance, the biggest problem is gaining access to a physician. Immigrants constitute a disproportionate number of the working ...
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For many of those among the working poor who lack coverage by medical insurance, the biggest problem is gaining access to a physician. Immigrants constitute a disproportionate number of the working poor families. Although progress had been made since the mid-1990s, this chapter reports that 44 percent of the immigrant children in working poor families were not covered by health insurance in 2001, along with 17 percent of the US born children of the working poor. The serious vulnerability of children in working poor families highlights the need for continued support of existing programs, such as Medicaid and the State Children's Health Insurance Program, so that they might be extended to the approximately 6 million uninsured children who are currently eligible for coverage. In addition to support for these programs, the chapter recommends that states provide universal coverage for all children along the lines of Governor Schwarzenegger's proposal to expand health insurance coverage for all uninsured Californians.Less
For many of those among the working poor who lack coverage by medical insurance, the biggest problem is gaining access to a physician. Immigrants constitute a disproportionate number of the working poor families. Although progress had been made since the mid-1990s, this chapter reports that 44 percent of the immigrant children in working poor families were not covered by health insurance in 2001, along with 17 percent of the US born children of the working poor. The serious vulnerability of children in working poor families highlights the need for continued support of existing programs, such as Medicaid and the State Children's Health Insurance Program, so that they might be extended to the approximately 6 million uninsured children who are currently eligible for coverage. In addition to support for these programs, the chapter recommends that states provide universal coverage for all children along the lines of Governor Schwarzenegger's proposal to expand health insurance coverage for all uninsured Californians.
Eric Helland and Jonathan Klick
- Published in print:
- 2010
- Published Online:
- May 2010
- ISBN:
- 9780195390131
- eISBN:
- 9780199775934
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195390131.003.010
- Subject:
- Law, Medical Law
This chapter argues that although concern for individuals with relatively high expected health care costs may justify significant cross-subsidization on normative grounds, it makes sense as a matter ...
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This chapter argues that although concern for individuals with relatively high expected health care costs may justify significant cross-subsidization on normative grounds, it makes sense as a matter of fairness and in terms of minimizing attendant efficiency losses to sever the employment link, enacting a program through which cross-subsidization occurs within society more generally. The chapter is organized as follows. Section 2 briefly reviews the literature on labor market distortions related to health insurance benefits. Section 3 discusses how many individuals are likely to be “uninsurable” in an insurance market in which coverage is not tied to a person's employer. Section 4 lays out the proposal to move individuals requiring subsidies to a broad-based pool financed through the federal tax system, and discusses the determinants of health insurance affordability and pricing mechanism. Section 5 discusses the necessary federalization of Medicaid and the abolition of state-level insurance mandates that accompany our proposal. Section 6 examines the experience of other countries in order to shed light on the efficacy of our proposal, and Section 7 concludes.Less
This chapter argues that although concern for individuals with relatively high expected health care costs may justify significant cross-subsidization on normative grounds, it makes sense as a matter of fairness and in terms of minimizing attendant efficiency losses to sever the employment link, enacting a program through which cross-subsidization occurs within society more generally. The chapter is organized as follows. Section 2 briefly reviews the literature on labor market distortions related to health insurance benefits. Section 3 discusses how many individuals are likely to be “uninsurable” in an insurance market in which coverage is not tied to a person's employer. Section 4 lays out the proposal to move individuals requiring subsidies to a broad-based pool financed through the federal tax system, and discusses the determinants of health insurance affordability and pricing mechanism. Section 5 discusses the necessary federalization of Medicaid and the abolition of state-level insurance mandates that accompany our proposal. Section 6 examines the experience of other countries in order to shed light on the efficacy of our proposal, and Section 7 concludes.
Peter A. Swenson
- Published in print:
- 2002
- Published Online:
- November 2003
- ISBN:
- 9780195142976
- eISBN:
- 9780199872190
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/0195142977.003.0012
- Subject:
- Political Science, American Politics
This chapter turns to the social democratic reforms of the 1940s and 1950s, rooted in cross‐class alliances that were ultimately to distinguish Sweden as the world's paragon social democratic welfare ...
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This chapter turns to the social democratic reforms of the 1940s and 1950s, rooted in cross‐class alliances that were ultimately to distinguish Sweden as the world's paragon social democratic welfare state. Looking first at its People's Pension and universal health insurance reforms, it shows how the Social Democratic government assisted organized employers in their efforts against welfare capitalism by relieving pressure on individual firms to use private social benefits to attract and retain labor under the labor scarcity associated with solidarism and strong expansionary macroeconomic pressures. It then looks at Sweden's renowned “active labor market policy” and its controversial pension legislation of 1959 to show how additional social democratic reforms directly served employers’ solidaristic interests in wage restraint, labor mobility, and the rationing of labor made scarce by collectively administered underpricing – all the while preserving capitalist domination of the investment process.Less
This chapter turns to the social democratic reforms of the 1940s and 1950s, rooted in cross‐class alliances that were ultimately to distinguish Sweden as the world's paragon social democratic welfare state. Looking first at its People's Pension and universal health insurance reforms, it shows how the Social Democratic government assisted organized employers in their efforts against welfare capitalism by relieving pressure on individual firms to use private social benefits to attract and retain labor under the labor scarcity associated with solidarism and strong expansionary macroeconomic pressures. It then looks at Sweden's renowned “active labor market policy” and its controversial pension legislation of 1959 to show how additional social democratic reforms directly served employers’ solidaristic interests in wage restraint, labor mobility, and the rationing of labor made scarce by collectively administered underpricing – all the while preserving capitalist domination of the investment process.
Jill Quadagno and J. Brandon McKelvey
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780195388299
- eISBN:
- 9780199866519
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195388299.003.0004
- Subject:
- Political Science, American Politics
Quadagno and McKelvey challenge traditional social movement distinctions between political “insiders” and “outsiders” in their analysis of the consumer‐directed health care (CDHC) movement, a ...
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Quadagno and McKelvey challenge traditional social movement distinctions between political “insiders” and “outsiders” in their analysis of the consumer‐directed health care (CDHC) movement, a loose‐knit coalition of insurance companies, financial services companies, advocacy organizations, and conservative politicians. The CDHC movement's primary goal has been to transform patients into informed consumers by characterizing medical care as a commodity that is purchased in the same way as other market goods. Quadagno and McKelvey argue that of all the social movement organizations that have sought to transform the financing of medical services in the United States, only the CDHC has succeeded in shifting the direction of the health care system. Unlike traditional characterizations of social movement organizations as operating at the margins of the political system, the CDHC movement consists of elite organizations with ample resources and the capacity to utilize the party system to their advantage. Despite such advantages, Quadagno and McKelvey argue, the CDHC movement shares with other social movements a desire to challenge existing health institutions and a need to devise tactics and strategies to use their resources to the best political advantage.Less
Quadagno and McKelvey challenge traditional social movement distinctions between political “insiders” and “outsiders” in their analysis of the consumer‐directed health care (CDHC) movement, a loose‐knit coalition of insurance companies, financial services companies, advocacy organizations, and conservative politicians. The CDHC movement's primary goal has been to transform patients into informed consumers by characterizing medical care as a commodity that is purchased in the same way as other market goods. Quadagno and McKelvey argue that of all the social movement organizations that have sought to transform the financing of medical services in the United States, only the CDHC has succeeded in shifting the direction of the health care system. Unlike traditional characterizations of social movement organizations as operating at the margins of the political system, the CDHC movement consists of elite organizations with ample resources and the capacity to utilize the party system to their advantage. Despite such advantages, Quadagno and McKelvey argue, the CDHC movement shares with other social movements a desire to challenge existing health institutions and a need to devise tactics and strategies to use their resources to the best political advantage.
Jane Banaszak-Holl, Sandra Levitsky, and Mayer Zald
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780195388299
- eISBN:
- 9780199866519
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195388299.001.0001
- Subject:
- Political Science, American Politics
Social Movements and the Transformation of American Health Care examines dynamics of change in health care institutions through the lens of contemporary theory and research on collective ...
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Social Movements and the Transformation of American Health Care examines dynamics of change in health care institutions through the lens of contemporary theory and research on collective action. Bringing together scholars from medicine, health management and policy, history, sociology, and political science, the book conceptualizes the American health care system as being organized around multiple institutions—including the state, biomedical fields, professions, and health delivery organizations. By shifting attention toward the organizing structures and political logics of these institutions, the essays in this book illuminate the diversity in both sites of health‐related collective action and the actors seeking transformations in health institutions. The book considers health‐related social movements at four distinct levels of analysis. At the most macro level, essays analyze social movements that seek changes from the state in the regulation, financing, and distribution of health resources. A second set of essays considers field‐level analyses of institutional changes in such wide‐ranging areas as public health, bio‐ethics, long‐term care, abortion, and AIDS services. A third set of essays examines the relationship between social movements and professions, examining the “boundary crossing” that occurs when professionals participate in social movements or seek changes in existing professions and the health practices they endorse. A final set of essays analyzes the cultural dominance of the medical model for addressing health problems in the United States and its implications for collective attempts to establish the legitimacy of particular issues, framings, and political actors in health care reform.Less
Social Movements and the Transformation of American Health Care examines dynamics of change in health care institutions through the lens of contemporary theory and research on collective action. Bringing together scholars from medicine, health management and policy, history, sociology, and political science, the book conceptualizes the American health care system as being organized around multiple institutions—including the state, biomedical fields, professions, and health delivery organizations. By shifting attention toward the organizing structures and political logics of these institutions, the essays in this book illuminate the diversity in both sites of health‐related collective action and the actors seeking transformations in health institutions. The book considers health‐related social movements at four distinct levels of analysis. At the most macro level, essays analyze social movements that seek changes from the state in the regulation, financing, and distribution of health resources. A second set of essays considers field‐level analyses of institutional changes in such wide‐ranging areas as public health, bio‐ethics, long‐term care, abortion, and AIDS services. A third set of essays examines the relationship between social movements and professions, examining the “boundary crossing” that occurs when professionals participate in social movements or seek changes in existing professions and the health practices they endorse. A final set of essays analyzes the cultural dominance of the medical model for addressing health problems in the United States and its implications for collective attempts to establish the legitimacy of particular issues, framings, and political actors in health care reform.
Alexandra Kaasch
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780199591145
- eISBN:
- 9780191594601
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199591145.003.0009
- Subject:
- Political Science, International Relations and Politics, Political Economy
Chapter 9 focuses on ideas about the organization of health systems as developed in and disseminated by the OECD Secretariat. Global health governance is characterized by an increasing number ...
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Chapter 9 focuses on ideas about the organization of health systems as developed in and disseminated by the OECD Secretariat. Global health governance is characterized by an increasing number of different global health actors including an increasingly active OECD. After defining the OECD's role in transnational health policy, its potential power to influence national policy‐making by disseminating particular ideas, and a broader overview of the OECD's health activities, this chapter presents and discusses the general OECD approach regarding health systems and analyzes the specific issue of private health insurance (PHI). In order to explore the potential impact of these ideas, some of the OECD Reviews of Health Care Systems and Economic Surveys are examined with regard to their specific recommendations concerning PHI. The chapter also discusses the content and coherence of the OECD ideas regarding PHI and the potential power of the OECD Secretariat to guide national health policy in this dimension.Less
Chapter 9 focuses on ideas about the organization of health systems as developed in and disseminated by the OECD Secretariat. Global health governance is characterized by an increasing number of different global health actors including an increasingly active OECD. After defining the OECD's role in transnational health policy, its potential power to influence national policy‐making by disseminating particular ideas, and a broader overview of the OECD's health activities, this chapter presents and discusses the general OECD approach regarding health systems and analyzes the specific issue of private health insurance (PHI). In order to explore the potential impact of these ideas, some of the OECD Reviews of Health Care Systems and Economic Surveys are examined with regard to their specific recommendations concerning PHI. The chapter also discusses the content and coherence of the OECD ideas regarding PHI and the potential power of the OECD Secretariat to guide national health policy in this dimension.
Robert I. Field
- Published in print:
- 2013
- Published Online:
- January 2014
- ISBN:
- 9780199746750
- eISBN:
- 9780199354528
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199746750.003.0006
- Subject:
- Public Health and Epidemiology, Public Health
Private health insurance emerged from the efforts of hospitals and physicians to devise alternative payment arrangements during the Great Depression. Two federal policiesfostered its spread during ...
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Private health insurance emerged from the efforts of hospitals and physicians to devise alternative payment arrangements during the Great Depression. Two federal policiesfostered its spread during and just after World War II. One forgeda link with employment by permitting companies to add health coverage under a wage freeze. The other enshrined the link by permitting workers to receive this benefit tax-free. The resulting tax subsidy today costs $250 billion a year. Federal policies nurtured further industry growth through Medicare and Medicaid, which include large administrative roles for private insurers, and the Affordable Care Act, which subsidizes the market for individual policies. Another federal initiative transformed the industry’s operational paradigm bylaunching managed care. Without government support, private health insurance would look quite different. Its link with employment would be weaker, it would include few, if any,managed care plans, and itwould generate much less in profits.Less
Private health insurance emerged from the efforts of hospitals and physicians to devise alternative payment arrangements during the Great Depression. Two federal policiesfostered its spread during and just after World War II. One forgeda link with employment by permitting companies to add health coverage under a wage freeze. The other enshrined the link by permitting workers to receive this benefit tax-free. The resulting tax subsidy today costs $250 billion a year. Federal policies nurtured further industry growth through Medicare and Medicaid, which include large administrative roles for private insurers, and the Affordable Care Act, which subsidizes the market for individual policies. Another federal initiative transformed the industry’s operational paradigm bylaunching managed care. Without government support, private health insurance would look quite different. Its link with employment would be weaker, it would include few, if any,managed care plans, and itwould generate much less in profits.
Aaron Bernstein
- Published in print:
- 2010
- Published Online:
- September 2010
- ISBN:
- 9780199592609
- eISBN:
- 9780191594618
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199592609.003.0013
- Subject:
- Business and Management, Pensions and Pension Management
Recent negotiations between the United Auto Workers (UAW) and Detroit automakers focused attention on an innovative response to the long‐term US decline in retiree health insurance. The union agreed ...
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Recent negotiations between the United Auto Workers (UAW) and Detroit automakers focused attention on an innovative response to the long‐term US decline in retiree health insurance. The union agreed to set up a trust called a voluntary employees' beneficiary association (VEBA) to assume responsibility for the UAW retiree medical care at the companies. An analysis of the General Motors Corporation VEBA suggests that it is a second‐best option to employer‐paid retiree coverage. However, absent comprehensive national health‐care reform, it may be a viable alternative for those unable to fend off the elimination of retiree health care provided by employers.Less
Recent negotiations between the United Auto Workers (UAW) and Detroit automakers focused attention on an innovative response to the long‐term US decline in retiree health insurance. The union agreed to set up a trust called a voluntary employees' beneficiary association (VEBA) to assume responsibility for the UAW retiree medical care at the companies. An analysis of the General Motors Corporation VEBA suggests that it is a second‐best option to employer‐paid retiree coverage. However, absent comprehensive national health‐care reform, it may be a viable alternative for those unable to fend off the elimination of retiree health care provided by employers.
Robert I. Field
- Published in print:
- 2006
- Published Online:
- September 2009
- ISBN:
- 9780195159684
- eISBN:
- 9780199864423
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195159684.003.0004
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter considers the financing of health care. It explains the history of private health insurance, including favorable tax and regulatory provisions that have sustained it over the years, and ...
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This chapter considers the financing of health care. It explains the history of private health insurance, including favorable tax and regulatory provisions that have sustained it over the years, and of public programs, including Medicare, Medicaid, and the State Children's Health Insurance Program. It also reviews the nature and evolution of managed care as an increasingly dominant form of coverage. The oversight of health care finance is extremely complex with an intricate and uncertain balance between federal and state authority. At the same time, payers, both pubic and private, have come to exert a large and growing influence over the actual provision of clinical care. The chapter ends with a discussion of perennial policy conflicts, including those between governmental and private financing, over intrusions by payers into clinical decision making, and over the seemingly intractable coverage gap for about 15 percent of the population.Less
This chapter considers the financing of health care. It explains the history of private health insurance, including favorable tax and regulatory provisions that have sustained it over the years, and of public programs, including Medicare, Medicaid, and the State Children's Health Insurance Program. It also reviews the nature and evolution of managed care as an increasingly dominant form of coverage. The oversight of health care finance is extremely complex with an intricate and uncertain balance between federal and state authority. At the same time, payers, both pubic and private, have come to exert a large and growing influence over the actual provision of clinical care. The chapter ends with a discussion of perennial policy conflicts, including those between governmental and private financing, over intrusions by payers into clinical decision making, and over the seemingly intractable coverage gap for about 15 percent of the population.
