THE TIME IS NEVER RIPE: The Repeated Defeat of Universal Health Insurance in the 20th Century United States. TWENTY SIXTH GEARY LECTURE, 1995

My presentation for today’s Geary lecture uses a recent episode in US politics - President Bill Clinton’s 1993 Health Security proposal for comprehensive health insurance reform, and the subsequent conservative political backlash against it - as a window into the history of attempts to create universal health insurance in the United States. This episode also reveals much about the present and probable future of social-welfare politics in the United States

Historicizing the Emergence of Global Mental Health in Nepal (1950-2019)

This article traces a genealogy of mental health governance in Nepal as it was constituted in and through an assemblage of historical events, local politics, personal relationships and trends in the field of global health development. The relation between health development and local politics in Nepal is explored across four periods in the history of global health: 1) the early health development programs of disease eradication after the end of the Rana oligarchy (1951-1970); 2) the turn to primary health care during the Panchayat (1970-1990); 3) the rise of NGOs and the People’s War (1990-2010); and 4) the return to health systems development in the post-conflict/post-earthquake period (2010-present). By drawing on a combination of archival research and a cross-disciplinary review of the literature on global mental health, this article tracks the changing projects of mental health development programs in Nepal over the past century. In doing so, it becomes possible to observe the shifting trends in the problematization of mental health and the management of psychic life in Nepal from 1950 to the emergence of global mental health

Review of Experiencing Politics by John E. McDonough

Reviews the book \u27Experiencing Politics: A Legislator\u27s Stories of Government and Health Care,\u27 by John E. McDonough

Medicine as Friendship with God: Anointing the Sick as a Theological Hermeneutic

A theological bioethics needs, first, a theological politics. The thesis of this essay rests on the claim that the contours of a theological politics are found in the nature of sacramental practices. More specifically, a theological politics of medicine is found in the sacramental practice of anointing of the sick. Anointing provides a radically theological hermeneutic—a theologically robust vision for interpreting medicine that, if enacted, can powerfully make real God\u27s work in the world. Such a vision is embodied in one particular twentieth-century exemplar—the organization called Partners In Health (PIH) and its cofounder, Paul Farmer. Farmer and PIH, I argue, live the théologie and theological politics of medicine embodied in the practice of anointing. What is more, they show—against those who would accuse such an approach of being naively idealistic—that such a theological politics is possible, powerful, and can even change the world

Medicine as Friendship with God: Anointing the Sick as a Theological Hermeneutic

A theological bioethics needs, first, a theological politics. The thesis of this essay rests on the claim that the contours of a theological politics are found in the nature of sacramental practices. More specifically, a theological politics of medicine is found in the sacramental practice of anointing of the sick. Anointing provides a radically theological hermeneutic—a theologically robust vision for interpreting medicine that, if enacted, can powerfully make real God\u27s work in the world. Such a vision is embodied in one particular twentieth-century exemplar—the organization called Partners In Health (PIH) and its cofounder, Paul Farmer. Farmer and PIH, I argue, live the théologie and theological politics of medicine embodied in the practice of anointing. What is more, they show—against those who would accuse such an approach of being naively idealistic—that such a theological politics is possible, powerful, and can even change the world

The New Politics of US Health Care Prices: Institutional Reconfiguration and the Emergence of All-Payer Claims Databases

Prices are a significant driver of health care cost in the United States. Existing research on the politics of health system reform has emphasized the limited nature of policy entrepreneurs’ efforts at solving the problem of rising prices through direct regulation at the state level. Yet this literature fails to account for how change agents in the states gradually reconfigured the politics of prices, forging new, transparency-based policy instruments called all-payer claims databases (APCDs), which are designed to empower consumers, purchasers, and states to make informed market and policy choices. Drawing on pragmatist institutional theory, this article shows how APCDs emerged as the dominant model for reforming health care prices. While APCD advocates faced significant institutional barriers to policy change, we show how they reconfigured existing ideas, tactical repertoires, and legal-technical infrastructures to develop a politically and technologically robust reform. Our analysis has important implications for theories of how change agents overcome structural barriers to health reform

Intergenerational Redistribution, Health Care, and Politics

Publicly provided health care implies considerable intergenerational redistribution. The possibility of accumulating a fund or debt will affect the degree of redistribution as well as how efficient the financing of health care is. In a voting model we study how governments inability to make binding long-term policy commitments will affect the accumulation of a fund or debt. Today's government will base its policy decisions on expectations about future governments behavior and simply follow suit, which results in strong political inertia. Either a fund or debt may therefore be upheld in political equilibrium. But no mechanism ensure that it is at its optimal level. If there is fund in steady state, the more political clout the old have the smaller will the fund be, i.e saving decrease. If there is debt, however, a politically stronger old generation may imply a smaller debt, i.e. savings increase.Voting; health expenditure; intergenerational transfers; dynamic politics

The politics of evidence: ‘Doing nothing’ about LGBT health inequities by the WHO

How is ‘nothing’ produced and justified, and how is it functioning? Here, I will take a multilateral debate in the World Health Organisation (WHO) over the issues regarding health inequities experienced by sexual and gender minorities as an example. This article asks what national delegates really mean when they blame on the lack of evidence? Observing the debates in the WHO and elsewhere, what certain national governments have been doing is to avoid – by not making anything happen – a potential formulation of future international pressure through global health policymaking and its normative discourse. Through deconstructing the discourse of a ‘lack of evidence’, I identify the socio-political functions of ignorance and ignoring. That is, they did nothing, not because they didn’t understand and care. Quite on the contrary, it was because they cared and knew too well that health is always political, and yet, it is not just the politics concerning knowledge production and media representation; it is also international politics

Conference schedule

The Intermountain West region, including Arizona, Colorado, Idaho, Nevada, New Mexico, and Utah, is the new swing region in American politics. Many national observers and commentators have only a superficial understanding of the profound economic, political, and social changes that continue to reshape this region. Brookings Mountain West is pleased to offer a collection of contemporary research papers on recent demographic trends that alter this region and its politics. These studies, including a public opinion survey that explores attitudes on state and national politics, alternative energy, education, deficits, health care, immigration, and other topics illuminate the political landscape of this region on the eve of the 2010 elections and in advance of the 2012 presidential race