The Politics and Political Economy of Health Care Reform: Change and Continuity in the United Kingdom and United States
Year: 2011
Type: preprint
Abstract: As the provision of health care takes up an increasing amount of economic resources across industrialized nations the politics surrounding efforts at health care reform have become ever more fiercely contested. This was illustrated in both the United States and the United Kingdom when significant health care reform agendas were advanced in the wake of a change in the partisan balance of power in Washington DC in 2009 and in London in 201'3 Opponents of the reforms, in particular, argued that the planned changes would fundamentally challenge existing arrangements. This paper examines just how radical the plans put forward in the Affordable Care Act and the Health and Social Care bill actually are. The paper draws upon the typology developed by Michael Moran in 2000 that depicted the UK as a ‘command and control’ health care state and the US as a ‘supply state’. The paper reflects on the institutional implications of these differences while asking whether those categorizations need rethinking in the light of the ACA and the planned changes for the NHS in England. The paper concludes that the changes to access to health insurance in the ACA do constitute a major break from existing practise. It is less clear that the efforts at cost control in the ACA will succeed in ‘bending the cost curve’. The likely impact of the HSC is also uncertain, particularly after the amendments made to the original bill diluted some of the initial efforts to encourage competition between health providers. The paper also points to the various factors that might derail effective implementation of the proposals.
Source: SSRN Electronic Journal
Author: Alex Waddan
Institution: University of Leicester
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2285938998