Health Care Reforms in the United States: Institutions, Alliances, and Policy Feedbacks

Award Year: 1993	Investigator: Theda Skocpol	Budget: $181,534	Categories: Health Reform, History of Health Policy and Public Health
Abstract: This project examines major episodes of actual and attempted U.S. health care reforms, dating from the 1930s to the 1990s. It analyzes changes and continuities in institutional contexts, political alliances, and policy feedbacks, i.e., the effects of earlier policies on later policymaking. It provides an intellectual framework for considering change in institutional and political contexts, within which reforms are debated and (if enacted) implemented, and analyzes their effects on subsequent political dynamics and reform. The analysis deals with the past for its own sake as well as large-scale institutional and political processes. It critically examines the strategic choices, successes, and errors of reform-minded experts. It draws clear lessons for advocates of broadening social access and controlling health care costs to use in strategic political choices during the 1990s and early 2000s.