Health Policy And Federalism

An examination of whether federal institutions influence policy outcomes in the health sector.

The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.

An exploration of the ways in which federal and provincial governments relate to one another, and to the citizenry, in the making of health policy.

Examining the changing nature of health care federalism within a competitive global context, Comparative Health Care Federalism provides a rich and nuanced account of the way in which the interplay of federal relationships impact health care within an array of systems. The editors have gathered together some of the leading international health policy scholars to provide detailed accounts of the dynamics of federal health policy-making within their respective jurisdictions. Complementing the theoretical and methodological objectives, this book provides a detailed, empirical description of the challenges faced by different states and the ways in which health policy-making works within the federal, quasi-federal, and functional federal systems presented. In chapters on the United States, Australia, Canada, Germany, Spain, Italy, Austria, the United Kingdom, the EU, India, China, Brazil, and the Russian Federation the authors consider what variables contribute to, and stand in the way of, the formation of robust and sustainable health care systems.

In the ongoing struggle between those favoring centralized and those favoring decentralized government, health care policy is an important issue. This book has three goals: (1) to illustrate how theories of federalism and intergovernmental relations can provide a useful framework for examining how to "divide up the job" in the health care area, (2) to assess the capacity of the states to actually implement health care policy changes, and (3) to weigh the merits of alternative visions of the future role of states and the federal government in health care policy.

Looking at Canada, Brazil, Germany, Mexico, Nigeria, Pakistan, South Africa and Switzerland, Federalism and Decentralization in Health Care examines the overall organization of the health system.

First published in 1997, this volume emerged in the ongoing struggle between those favouring centralized and those favouring decentralized government, and has three goals: 1) To illustrate how theories of federalism and intergovernmental relations can provide a useful framework for examining how to 'divide up the job in the health care area'; 2) To assess the capacity of the states to actually implement health care policy changes; 3) To weigh the merits of alternative visions of the future roles of states and the federal government in health care policy.