The Congressional Graveyard for Health Care Reform
The Congressional Graveyard for Health Care Reform
This chapter argues that Congress may be called the graveyard of major health reforms. It begins by examining the institutional setting of U.S. governance in which Congress is embedded and highlights the challenges this generally poses for large-scale policy making compared with of other countries. The chapter then examines the problem of coalition building in legislatures to illustrate the challenges and opportunities engendered by Congress in the twentieth century. It highlights the manner in which the system's institutional features and health-care politics have changed over time, creating different opportunities for coalition building, and then explains why those opportunities have been missed or ineffectively pursued. The chapter concludes with some ideas for enhancing future opportunities to enact universal coverage.
Keywords: Congress, health reforms, policy making, coalition building, health-care politics
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