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Health Politics and PolicyThis research program focuses on the politics of national health policymaking. In contrast to much of the existing research in this area, the emphasis is comparative (across policy areas and decision-making contexts), longitudinal, and quantitative. Current ResearchThe Changing Health Agenda of Congress (1946-2000) Health policy making in Congress has traditionally been studied from the perspective of a particular issue, such as Medicare. Scholars of the institution, in contrast, emphasize the importance of understanding the broader context that shapes policy making in a particular area. The purpose of this project is to introduce context into the study of health policy making, and by doing so, improve our understanding of the institution. The research objective is to study and explain, systematically, why some health issues receive attention in Congress while others do not. We portray the legislative process as a winnowing process, so that attention to an issue can be measured both over time and by intensity of focus. Most of these data (media attention, congressional hearings, budget authorizations, statutes) are already available through the Agendas Project managed by the Center for American Politics and Policy. The remaining piece of the puzzle, introduced bills, is also one of the most technically challenging. Once constructed, this data set will provide new research opportunities for health scholars interested in better understanding the ebb and flow of attention to different health policy issues at the national level. Completed ResearchLocal Television News Coverage of President Clinton's Introduction of the Health Security Act Journal of the American Medical Association, 1996) examines the role of the media in legislative agenda setting by comparing how national health care reform was presented to the public by television news, how it was presented to Congress by President Clinton, and what was contained in the legislation itself. This study was noteworthy for the scope of the analysis (we coded the hundreds of television news stories for content), and for its insights into how public agendas are framed by the press. We found (as others have) that the media focused disproportionately on the politics of the reform effort. However, we also found that when television news focused on the issues, it focused disproportionately on the expected costs of reform and thus downplayed its potential benefits. Health Care Reform, 104th Congress: A Description of the Activities and Influence of Public Health Services (American Journal of Public Health, 1997), we examined how lobbying efforts shaped the public health aspects of the leading eight health care reform bills of 1994. Although this article primarily described the results of our interviews with congressional staff and interest group representatives, we were also able draw some general lessons about effective and less effective congressional lobbying tactics in the health arena. Money, Politics and Medicine: The American Medical Political Action Committee's Strategy of Giving in U.S. House Races (Journal of Health Politics Policy and Law, April 1999) This research project challenged the prevailing perception in the public health community that the American Medical Association's PAC rewards and punishes members of Congress for their roll call votes. This perception was based on prominent studies demonstrating a statistically significant association between voting positions and average contributions. We show that this association is no longer significant when indicators of the AMA's desire for access and the promotion of a conservative political agenda are introduced into the same model. Competitive Managed Care: The Emerging Health Care System (1997, Jossey-Bass) This edited volume was motivated by the rapid changes in California's health care system during the mid-1990s. Many experts at the time argued that California was "different" and that state cultures would prevent managed care from taking hold in other places. The goal of the book was to provide a theoretical framework for thinking about the consequences of what we believed would be a national revolution in health care organization and delivery. If managed care was to be the market's response to the problem of controlling health care costs, following the unequivocal rejection of a government response in 1993-94, then how successful was the market likely to be? What legitimate role, if any, was there for government in a managed care marketplace? And what role was government likely to play? The chapters, organized around a political economy framework, examined recent private and government responses to the challenges of promoting an efficiently operating health care market. In the introductory and concluding chapters, we offer a framework designed to help researchers and activists better understand the potential strengths and limitations of managed care as a market response. |
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© 2004 Center for American Politics & Public Policy, University of Washington |