The origin of this book can be traced to our previous one, Health Care Politics and Policy in America ( 1995). That book was completed before the conclusion of the 104th Congress with its concentration on budget reduction and health programs, such as Medicare, Medicaid, and insurance reform. Given the failures of that Congress with Medicare and Medicaid and the passage of health reform legislation, we thought it would be valuable to contrast the 1993-94 period, characterized by attempted expansion of health programs and presidential initiatives, with the 1995-96 period, characterized by attempted retrenchment and congressional initiative. Further, several books and a number of academic studies have focused on the earlier period, but not many on the latter period.
We presented this project to Patricia Kolb, the executive editor at M. E. Sharpe, but not as just another book on health policy. Instead, we saw the opportunity to use the mid-1990s attempts at health care reform to illustrate the workings of the policy process within the American political system. (Pat encouraged our efforts, demonstrating to us her insightfulness).
So this is not just another book on health policy; we already wrote that. The purpose of this book is much broader. It uses health care reform as a vehicle for understanding the potential and limits of American policy making as we approach the end of the twentieth century. The book examines a variety of factors and institutional venues that shape policy successes and failures. Individual chapters focus on the agenda-building process and the role of the president, Congress, interest groups, mass media, and public opinion in American democracy. Parties and elections factor into institutional deliberations and are interspersed throughout the book. Additionally, there is considerable discussion of health care policy proposals. Thus, Politics, Power, and Policy Making. The Case of Health Care Reform in the 1990s is appropriate not only for those interested in health care politics and