Politics, Power & Policy Making: The Case of Health Care Reform in the 1990s

By Mark E. Rushefsky; Kant Patel | Go to book overview

1 SETTING THE STAGE

Our story begins in April 1991 with the death of Pennsylvania Senator John Heinz in a small plane crash. It ends in November 1996, with presidential and congressional elections. In between were some of the most intensive attempts at reform of the health care system that the United States has seen.

While our focus is on health care, our purpose is much larger than that. Our goal is to use health care as the vehicle for exploring various aspects of American politics and government, such as the presidency, Congress, interest groups, and agenda building.

Recent books have also concentrated on the fascinating story of health care reform and the political changes of the mid-1990s. Balz and Brownstein ( 1996) look at the politics leading to the takeover of Congress by the Republicans in 1995. Elizabeth Drew ( 1996) chronicles the contentious relations between the Republican-controlled 104th Congress and Democratic president Bill Clinton, as does Maraniss and Weisskopf ( 1996). All three books touch upon the health reform battles.

Two other books look more explicitly at health care reform. Johnson and Broder ( 1996) thoroughly examine the health reform debates from 1993 to 1995. They use those debates as a prism to suggest that the American political system is breaking down. Skocpol ( 1996) examines how the conflict over Clinton Health Security Act inadvertently fueled a growing antigovernment tide. We ( Patel and Rushefsky 1995) have also made our contribution with a comprehensive examination of the health care system. So why another book on health care?

Our plan is to use health care reform to explore various theories and concepts in political science as a way of understanding how public policy is made or not made. We divide the health care reform battles into two parts. One part focuses on comprehensive reform proposals associated with presidential leadership. The second part focuses on more incremental, but still significant, proposals highlighted by congressional leadership. This com-

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Politics, Power & Policy Making: The Case of Health Care Reform in the 1990s
Table of contents

Table of contents

  • Title Page iii
  • Contents vii
  • List of Tables and Figures ix
  • Preface xi
  • Acknowledgments xii
  • 1 - Setting the Stage 3
  • 2 - Health Care Reform Returns to the National Agenda: The Winds of Change 16
  • Conclusion 49
  • 3 - Presidential Leadership and Policy Making 51
  • Conclusion 86
  • 4 - Congress and Health Care 89
  • Conclusion 137
  • 5 - Interest Groups 140
  • Conclusion 169
  • 6 - The Role of the Mass Media in the Policy Process 173
  • Conclusion 209
  • 7 - Public Opinion and Health Care Policy 211
  • 8 - Politics, Power, and Policy Making 243
  • Chronology 255
  • References 273
  • Index 297
  • About the Authors 313
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