Dynamic Institutions and National Health Care Policy Making

Award Year: 1994	Investigator: Mark Peterson	Budget: $1,281	Categories: History of Health Policy and Public Health, Politics and Policymaking
Abstract: Beginning with the New Deal, Dr. Peterson explores the ways in which political and governmental institutions respond to the stimulus for public action, direct the choice of policy alternatives, and are influenced by various leadership activities. In related projects, two distinct patterns of health care policymaking are studied. The first concentrates on systemic policy change, assessing the debate over comprehensive health care reform in the context of past failures. It emphasizes the role of macro-level changes in interest groups, Congress, legislative political parties, and the presidency in explaining both the enhanced prospects of comprehensive reform in the 1990s and barriers to change. The second deals with normal policy, investigating health policy ranging from incremental adjustments like direct reimbursement of nurse practitioners under Medicare to major issues, such as AIDS. In this realm, the explanation of policy outcomes emphasizes the role of micro-level interactions among elected and non-elected public officials, interest groups, policy specialists, and activists, which vary across policy communities and over time.