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Health Care and the Hill: Why Is This Year Different From All Others?

Published online by Cambridge University Press:  02 September 2013

Mark A. Peterson*
Affiliation:
University of Pittsburgh

Extract

Before us is the question of whether or not the 103rd Congress will manage to do what no other U.S. Congress has ever accomplished: the enactment of a comprehensive reform of the way in which health care services are financed in the United States. Does a social science perspective give us a reason to believe that 1994 will be a legislative year that is different from all others? Conventional wisdom might well suggest a simple answer: “no.” Given what we know about the complexity of the issue, the enormous stakes in the system possessed by some of the most powerful private interests, the fragmentation of our governing institutions, the paralysis produced by deficit politics, and the general presumed enthusiasm in our system for caution and incrementalism, a large-scale transformation of health care financing by a legislature best known for parochialism, timidity, and gridlock would seem implausible at best. Can the institution that stimulated scholarly and popular assessments from Congress: The Electoral Connection (Mayhew 1974) to Hill Rat: Blowing the Lid off Congress (Jackley 1992) really overcome the well-known and thoroughly studied barriers to major policy change, especially in the wake of a health care reform proposal from President Bill Clinton that could legitimately prompt the estate of Rube Goldberg to sue for plagiarism (S 1757, HR 3600)?

Rather than “no,” however, the answer really is that we simply do not know. President Clinton's proposed Health Security Act is typically introduced in the media as the most ambitious social policy initiative since the New Deal and social security.

Type
Research Article
Copyright
Copyright © The American Political Science Association 1994

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References

Arnold, R. Douglas. 1990. The Logic of Congressional Action. New Haven: Yale University Press.Google Scholar
Blendon, Robert J., Altman, Drew E., Benson, John M., Brodie, Mollyann, James, Matt, and Hugick, Larry. 1994. “How Much Does the Public Know About Health Reform?The Journal of American Health Policy 4 (January/February): 2631.Google ScholarPubMed
Brown, Lawrence D. 1992. “Getting There: The Political Context for Implementing Health Care Reform.” In Implementation Issues and National Health Care Reform, ed. Brecher, Charles. Washington, D.C.: Josiah Macy, Jr. Foundation.Google Scholar
Fein, Rashi. 1993. “The Politics of Health Reform: An Interim Report.” Presented at the Session on the Politics of Health Care Reform, Seminar on Future Directions for American Politics and Public Policy, Harvard University.Google Scholar
Jackley, John L. 1992. Hill Rat: Blowing the Lid Off Congress. Washington, D.C.: Regery Gateway.Google Scholar
Kosterlitz, Julie. 1991. “Radical Surgeons.” National Journal April 27:993–97.Google ScholarPubMed
Marmor, Theodore R. 1973. The Politics of Medicare. Chicago: Aldine.Google Scholar
Mayhew, David R. 1974. Congress: The Electoral Connection. New Haven: Yale University Press.Google Scholar
Oppenheimer, Bruce I. 1980. “Policy Effects of U.S. House Reform: Decentralization and the Capacity to Resolve Energy Issues.” Legislative Studies Quarterly 5 (February):530.CrossRefGoogle Scholar
Pear, Robert. 1994. “Lawmakers Say Clinton Care Plan Can't Pass.” New York Times February 24:A1.Google Scholar
Peterson, Mark A. 1992a. “Report from Congress: Momentum toward Health Care Reform in the U.S. Senate.” Journal of Health Politics, Policy and Law 17 (Fall):553–73.CrossRefGoogle Scholar
Peterson, Mark A. 1992b. “Leading Our Way to Health: Entrepreneurship and Leadership in the Health Care Reform Debate.” Presented at the Annual Meeting of the American Political Science Association, Chicago, Illinois.Google Scholar
Peterson, Mark A. 1992c. “Health Policy Making in the Information Age: Is Congress Better Informed than the President?” Presented at the Conference on Governance in an Era of Skepticism: Administrators and Politicians, sponsored by the International Political Science Association Research Committee on the Structure and Organization of Government, Stockholm, Sweden.Google Scholar
Peterson, Mark A. 1993a. “Political Influence in the 1990s: From Iron Triangles to Policy Networks.” Journal of Health Politics, Policy and Law 18 (Summer):395438.CrossRefGoogle ScholarPubMed
Peterson, Mark A. 1993b. “Institutional Change and the Health Politics of the 1990s.” American Behavioral Scientist 36 (July):782801.CrossRefGoogle Scholar
Peterson, Mark A. 1993c. “National Health Care Reform and Social Learning: More Than Just the Facts.” Presented at the Annual Meeting of the American Political Science Association, Washington, D.C. Google Scholar
Rubin, Alissa J. 1993. “All Will Touch the Reform Bill, But Rules Panel Will Shape It.” Congressional Quarterly Weekly Report November 6:3050–52.Google Scholar
Rubin, Alissa J. 1994a. “CBO Turns Budget Spotlight on Health-Care Overhaul.” Congressional Quarterly Weekly Report February 12:290–91.Google Scholar
Rubin, Alissa J. 1994b. “How the CBO Sees It.” Congressional Quarterly Weekly Report February 12:291.Google Scholar
Rubin, Alissa J., and Donovan, Beth. 1994. “Clinton Uses His ‘Veto Pen’ To Draw Line in Debate.” Congressional Quarterly Weekly Report January 29:174–75.Google Scholar
Starr, Paul. 1982. The Social Transformation of American Medicine. New York: Basic Books.Google Scholar
Starr, Paul. 1991. “The Middle Class and National Health Reform.” The American Prospect 6 (Summer):712.Google Scholar
Stimson, James. 1994. “Dynamic Representation.” Presented in seminar series sponsored by the Center for American Politics and Society, Department of Political Science, University of Pittsburgh, January 28.Google Scholar