Politics, Power and Policy Making


Book Description

Tracking the issues of healthcare reform through the tumultous 1990s, this work opens a window on the changing dynamics of American politics from the Clinton inauguration in January 1993 through the Republican revolution of 1995 and the 1996 presidential race.




Health Objectives 2000 Act


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Nursing, Policy and Politics in Twentieth-century Chile


Book Description

This book offers the first in-depth account of healthcare policy in Chile across the twentieth century. It charts how nursing and nurses intersected with the political context of healthcare, with a focus on the country’s transition across welfare systems. Drawing on extensive archival research and interviews with nurses and governmental representatives, this book explores how the nursing profession implemented and challenged reform, while policies had an impact on nurses. It analyses nurses’ employment and mobility, and their lobbying through the press and through unions. The authors demonstrate that while Chilean health policy was influenced by US cultural politics, reform depended on the flexibility and willingness of nurses to carry through reforms. By examining the participation of the largest female professional group, the book offers new insights into the privatization of society on the pinnacle of industrial development and seeks to contribute to contemporary debates on Chile’s welfare system. It is a vital read for scholars researching the history of public health.




The Health Marketplace


Book Description

Health care provision in the United States remains a critical policy issue. Despite large-scale organizational transformations in hospitals, changes in the ways that health care is delivered, and changes in the relations between patients and the staffs who provide health care services, health institutions remain financially unstable even as they have grown in size. Mergers and new networks and systems have emerged, and revenue streams continue to grow. Experts no longer view such developments as holding the answer to continuing problems of the health care system. Focusing on changes in the health care sector in New York City during the 1990s, this volume considers physicians and other health care workers, primary and ambulatory care sites, and hospitals and medical centers. It explores the impact of institutional realignments and managed care in New York City. It examines the accelerated destabilization of health care financing and delivery at the end of the twentieth century in the nation at large as well as in New York State and New York City. Ginzberg and his colleagues describe what might happen in the next decade in the nation's largest metropolis and locate the probable outcome in the space between these two extremes. They focus on how the health marketplace may be altered by 2010 when it faces its greatest challenges, a year before the first members of the baby boom generation become eligible for Medicare. This literate and informative volume elucidates changes that have occurred in the health care sector during the decade of the 1990s and offers an expert assessment of what might happen over the next decade. Policymakers, health care officials, and medical personnel will find this highly informative reading. Eli Ginzberg is A. Barton Hepburn Professor Emeritus at the Graduate School of Business, and Director of the Eisenhower Center for the Conservation of Human Resources at Columbia University. His work in social policy, health care, human resources, the special needs of the poor, the young and the aged, place Ginzberg in a special category: activist scholar rather than academic-turned-activist. Howard Berliner is associate professor, Program in Health Services Management and Policy, Milano Graduate School of Management and Urban Policy, New School for Social Research. Panos Minogiannis is a political science doctoral candidate in the division of Sociomedical Sciences, Columbia University and a research associate at the Eisenhower Center. Miriam Ostow was the long term chief of health policy studies at the Eisenhower Center and co-author of many of its earlier publications on health policy.




Federalism and Health Policy


Book Description

The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.




The Future of the Public's Health in the 21st Century


Book Description

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.




Fulfilling America's Promise


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Workforce Policies for the 1990s


Book Description

The Economic Policy Institute (EPI) was founded in 1986 with the intent of widening the debate on U.S. economic policies by presenting analyses that provide an alternative point of view from those of various conservative research institutions. The two papers presented in this document were originally prepared for a seminar designed to identify principles upon which new labor market policies might be launched. In "The Possibilities of Employment Policy", Paul Osterman argues that current programs isolate and stigmatize their clients. Programs for dislocated workers respond to emergencies in an inevitably limited way, and current political support for employment and training systems is limited. Revived programs should include an expansion of eligibility, a unification of programs under a broadly representative local agency, a rethinking of the entry process for young people, and an expansion of the general training made available to employed adults. In "A New Labor Market Agenda" Ray Marshall also advocates a broad national strategy, but stresses that tight budgets require quality programs be built for those who most need them. He points out that graduates of proven programs such as the Job Corps are not stigmatized, and that such programs should be fully funded. Existing programs should be strengthened by developing managerial capacities and pursuing a consistency in funding. Basic education in the school systems is a major factor determining the success or failure of programs such as the adjustment of dislocated workers or the breaking of inter-generational poverty. Discussions by seminar participants follow each paper, and a list of EPI study series, working papers, and briefing papers is included. (PPB)




Employment and Health Benefits


Book Description

The United States is unique among economically advanced nations in its reliance on employers to provide health benefits voluntarily for workers and their families. Although it is well known that this system fails to reach millions of these individuals as well as others who have no connection to the work place, the system has other weaknesses. It also has many advantages. Because most proposals for health care reform assume some continued role for employers, this book makes an important contribution by describing the strength and limitations of the current system of employment-based health benefits. It provides the data and analysis needed to understand the historical, social, and economic dynamics that have shaped present-day arrangements and outlines what might be done to overcome some of the access, value, and equity problems associated with current employer, insurer, and government policies and practices. Health insurance terminology is often perplexing, and this volume defines essential concepts clearly and carefully. Using an array of primary sources, it provides a store of information on who is covered for what services at what costs, on how programs vary by employer size and industry, and on what governments doâ€"and do not doâ€"to oversee employment-based health programs. A case study adapted from real organizations' experiences illustrates some of the practical challenges in designing, managing, and revising benefit programs. The sometimes unintended and unwanted consequences of employer practices for workers and health care providers are explored. Understanding the concepts of risk, biased risk selection, and risk segmentation is fundamental to sound health care reform. This volume thoroughly examines these key concepts and how they complicate efforts to achieve efficiency and equity in health coverage and health care. With health care reform at the forefront of public attention, this volume will be important to policymakers and regulators, employee benefit managers and other executives, trade associations, and decisionmakers in the health insurance industry, as well as analysts, researchers, and students of health policy.