Who Pays for Health Care Reform?

In this second of three chapters on the distinctive policy dynamics of particular areas of social provision, Susan Giaimo addresses the issue of whether the success of the reformed welfare state in the shape of payers’ and policy makers’ cost‐containment projects have had as their price the sacrifice of equity and solidarity. These questions are explored through the lens of health care reform in Britain, Germany, and the US since the late 1980s: each a country with a distinctive health care system, which undertook major reform initiatives designed to control health care outlays, and addressed the efficiency and equity goals in markedly different ways. Section I provides a broad background to situate the contemporary politics of health care reform, explaining how and why health care systems in Western countries have come under the stress of increasing cost pressures even as governments and employers have become more apprehensive about the possible effects of the welfare state on economic competitiveness. Section 2 develops the argument in greater depth, explaining how existing health care and political systems provide different opportunities or constraints for payers and the state to pursue unilateral cost‐containment strategies, how health care institutions themselves shape policy preferences and strategies of payers, and how some systems require compromise solutions that reconcile equity with efficiency. Section 3 presents each country\u27s case, and the concluding section considers the broader lessons from health care reform for the contemporary politics of welfare state adjustment

Behind the Scenes of the Patient Protection and Affordable Care Act: The Making of a Health Care Co-op

A primary goal of the Patient Protection and Affordable Care Act (PPACA) is to reduce the number of uninsured by making health insurance more affordable for small businesses and individuals. Toward that end, the PPACA encourages the creation of nonprofit, member-owned health insurance cooperatives to operate inside each state exchange. Co-ops face significant challenges in entering mature insurance markets, but they also possess unique characteristics that may help them survive and thrive. Using Common Ground Healthcare Cooperative in Wisconsin as a case study, this article traces the origins of co-ops in health care reform at national and state levels and analyzes the political and technical challenges and opportunities facing these organizations

Neurons, Genes, and Policies: How Science Can Contribute to Trauma-Informed Policies

Science changes our views of the causes of poverty: No longer moral failure/bad choices of individuals Socioeconomic forces fundamentally shape our biology, but at level of genes and neurons Hopefully this can change the discussion around poverty Science can give us new tools to develop more effective policies addressing povert

Reforming Health Care in the United States, Germany, and South Africa

How do nations address the above health policy goals and respond to current challenges? As these four cases (United States, Germany, Canada, and South Africa) demonstrate, the answer lies in the underlying politics of health policy at work.https://epublications.marquette.edu/marq_fac-book/1283/thumbnail.jp

Markets and Medicine : The Politics of Health Care Reform in Britain, Germany, and the United States

Are advanced industrialized countries converging on a market response to reform their systems of social protection? By comparing the health care reform experiences of Britain, Germany, and the United States in the 1990s, Susan Giaimo finds that countries have pursued diverse policy responses and that such variations reflect distinctive institutions, actors, and reform politics in each country. In Britain, the Thatcher government\u27s plan to inject a market into the state-administered national health service resulted in a circumscribed experiment orchestrated from above. In Germany, the Kohl government sought to repair defects in the corporatist arrangement with doctors and insurers, thus limiting the market experiment and designing it to safeguard and even enhance the solidarity of the national health insurance system. In the United States, private market actors foiled President Clinton\u27s bid to expand the federal government\u27s role in the private health care system through managed competition and national insurance. But market reform continued, albeit led by private employers and with government officials playing a reactive role. Actors and institutions surrounding the existing health care settlement in each country created particular reform politics that either militated against or fostered the deployment of competition. Nevertheless, major transformations in governance arrangements are occurring in private as well as public systems of social protection. This finding suggests that studies of change in social policy expand their focus beyond statutory welfare state reform in advanced industrial societies. This book will be of interest to social scientists concerned with the changing balance among state, market, and societal interests in governance, as well as to health policy researchers, health policymakers, and health care professionals.https://epublications.marquette.edu/marq_fac-book/1314/thumbnail.jp