Diminishing Democracy in Health Policy: Partisanship, the Courts, and the End of Health Politics as We Knew It

2020 ◽  
Vol 45 (5) ◽  
pp. 757-769
Author(s):  
James A. Morone
Keyword(s):  
Health Care ◽  
New Deal ◽  
Affordable Care Act ◽  
Federal Court ◽  
Legislative Process ◽  
Court System ◽  
New Era ◽  
Health Politics ◽  
Health Care Politics ◽  
Slow Rise

Abstract Despite unprecedented partisanship, the Affordable Care Act (ACA) traced a familiar political arc: a loud debate full of dramatic symbols, a messy legislative process, clashes over implementation, a slow rise in popularity, entrenchment as part of the health care system, and growing support that blocked Congress from repealing. The politics of the ACA looked, from one angle, like a louder version of health politics as usual. But something new was stirring. Opponents pushed the debate outside the elected branches of government and into the courts—a move that reflects past eras of highly racialized conflict. A federal court marked the ACA's tenth anniversary by doing what Congress could not: it struck down the law, although the litigation continues to wend its way through the court system. The ongoing challenge to the ACA rests on a fundamental critique of the entire New Deal dispensation in jurisprudence. The consequence could be a new era in health care politics.

scholarly journals The Affordable Care Act in the States: Fragmented Politics, Unstable Policy

2020 ◽  
Vol 45 (4) ◽  
pp. 647-660
Author(s):  
Daniel Béland ◽  
Philip Rocco ◽  
Alex Waddan
Keyword(s):  
Health Care ◽  
Affordable Care Act ◽  
Political Polarization ◽  
Successful Implementation ◽  
Political Struggle ◽  
Health Care Politics ◽  
Quality Health ◽  
The Law ◽  
Institutional Fragmentation ◽  
Trump Administration

Abstract Many argue that the frustrated implementation of the 2010 Affordable Care Act (ACA) stems from the unprecedented level of political polarization that has surrounded the legislation. This article draws attention to the law's “institutional DNA” as a source of political struggle in the 50 states. As designed, in the context of US federalism, the law fractured authority in ways that has opened up the possibility of contestation and confusion. The successful implementation of the ACA varies not only across state lines but also across the various components of the law. In particular, opponents of the ACA have experienced their greatest successes when they could take advantage of weak preexisting policy legacies, high levels of institutional fragmentation, and negative public sentiments. As argued in this article, the fragmented patterns of health care politics in the 50 states identified in previous research have largely persisted during the Trump administration. Moreover, while Republicans were unsuccessful at repealing the legislation, the administration has taken advantage of its structural deficiencies to further weaken the legislation's capacity to expand access to affordable, quality health insurance.

Public Opinion and the Legislative Process

1946 ◽  
Vol 40 (5) ◽  
pp. 924-935 ◽  
Author(s):  
Frank V. Cantwell
Keyword(s):  
Public Opinion ◽  
Supreme Court ◽  
Federal Court ◽  
Interesting Case ◽  
Legislative Process ◽  
Court System ◽  
Clear Cut ◽  
Federal Judiciary ◽  
Important Relationship ◽  
The Supreme Court

The rôle played by public opinion in a democracy, particularly as it affects the legislative process, has long been a subject for speculation by political scientists. The advent of controlled quota sampling permits of the study of this important relationship in measurable terms. The object of the present discussion is to trace the interaction of public opinion and the executive and legislative branches of government as they have dealt with a single public question—reorganization of the Supreme Court, as presented to Congress for consideration by President Roosevelt on February 5, 1937. Enlargement of the Supreme Court from nine to fifteen members was the most controversial feature of the general reorganization of the federal judiciary proposed by the President, aimed at speeding up the process of clearing cases through the federal court system, and making the system more “representative” of the wishes of the people.The debate on enlargement of the Supreme Court provides a useful and interesting case study for several reasons. The case as a public issue has a definite beginning and end, ranging from the proposal of the judiciary reform bill by the President on February 5 to the death of Senator Joseph T. Robinson on July 14, 1937. As it was debated by public and legislators, the issue was a relatively clear-cut one, uncomplicated by side issues or utterly foreign events that might have influenced the course of either legislators or the public. Finally, and of decided importance, the American Institute of Public Opinion made weekly measurements of opinion toward the proposal during the entire period that reorganization of the Court was a public question. This permits the correlation of reliable opinion samplings with events in the debate and the observation of their relationship.

scholarly journals Health-Care Politics in the United States

2020 ◽  
Author(s):  
Lauren Peterson ◽  
Colleen Grogan
Keyword(s):  
United States ◽  
Health Care ◽  
Social Factors ◽  
Health Inequities ◽  
The United States ◽  
Cultural Economic ◽  
Health Politics ◽  
Government Institutions ◽  
Health Care Politics ◽  
Health Factors

Comparative studies of health care in the United States and peer nations often highlight a number of distinct features of the American system including high costs, fragmentation, and health inequities. While unique political factors and institutions in the United States are prominent reasons for these disparities, there are also distinct interactions between American politics and cultural, economic, racial, and social factors. Many comprehensive overviews of American health politics and policy begin in the 20th century highlighting the important influence of global and national historical events, such as World Wars I and II, and social movements, including the civil rights movement. Yet, health-care politics in the United States also continues to be shaped by early American history, government institutions, and systems. To understand health-care policy in the United States, it is also necessary to consider the legacy of other non-health factors and their intersections with health politics, including slavery and ongoing racism, early Protestant notions of mortality and self-reliance, the localized nature of private charity and volunteerism, federalism, a public distrust of federal government, and the evolution of health professions, among other factors. Often these historical events and other cultural, economic, or social factors significantly shape public opinion, political participation, and health-care inequities, and in some cases, provide a window of opportunity to advance important health-care reforms. The structure of American government institutions, political parties and growing polarization, unique attributes of elected leaders or policy entrepreneurs, and the power of interest groups, particularly private actors in the health care delivery system, are all significant factors that shape health-care politics in the United States. Contemporary American public health policy literature focuses on efforts to reduce health inequities and improve access to health care as well as the politics of recent reform ideas that promote government regulation and investments in non-health factors such as the environment and social services to reduce population health inequities.

Transformations: The New Deal through the 1950s

2017 ◽  
Author(s):  
Nancy Woloch
Keyword(s):  
Women Workers ◽  
New Deal ◽  
Federal Court ◽  
Labor Standards ◽  
Equal Rights ◽  
Single Sex ◽  
Fair Labor Standards Act ◽  
The 1950S ◽  
The 1960S ◽  
The New Deal

This chapter traces the changes in federal and state protective policies from the New Deal through the 1950s. In contrast to the setbacks of the 1920s, the New Deal revived the prospects of protective laws and of their proponents. The victory of the minimum wage for women workers in federal court in 1937 and the passage in 1938 of the Fair Labor Standards Act (FLSA), which extended labor standards to men, represented a peak of protectionist achievement. This achievement rested firmly on the precedent of single-sex labor laws for which social feminists—led by the NCL—had long campaigned. However, “equal rights” gained momentum in the postwar years, 1945–60. By the start of the 1960s, single-sex protective laws had resumed their role as a focus of contention in the women's movement.

Health Care Politics and Policy in New York State

2012 ◽  
Author(s):  
Michael K. Gusmano ◽  
Courtney Burke ◽  
Frank J. Thompson
Keyword(s):  
Health Care ◽  
New York ◽  
New York State ◽  
York State ◽  
Health Care Politics

scholarly journals How Do Machines Learn? Artificial Intelligence as a New Era in Medicine

2021 ◽  
Vol 11 (1) ◽  
pp. 32
Author(s):  
Oliwia Koteluk ◽  
Adrian Wartecki ◽  
Sylwia Mazurek ◽  
Iga Kołodziejczak ◽  
Andrzej Mackiewicz
Keyword(s):  
Artificial Intelligence ◽  
Machine Learning ◽  
Health Care ◽  
Medical Data ◽  
General Process ◽  
New Era ◽  
Automated Evaluation ◽  
Machine Learning Applications ◽  
And Training ◽  
Current Standards

With an increased number of medical data generated every day, there is a strong need for reliable, automated evaluation tools. With high hopes and expectations, machine learning has the potential to revolutionize many fields of medicine, helping to make faster and more correct decisions and improving current standards of treatment. Today, machines can analyze, learn, communicate, and understand processed data and are used in health care increasingly. This review explains different models and the general process of machine learning and training the algorithms. Furthermore, it summarizes the most useful machine learning applications and tools in different branches of medicine and health care (radiology, pathology, pharmacology, infectious diseases, personalized decision making, and many others). The review also addresses the futuristic prospects and threats of applying artificial intelligence as an advanced, automated medicine tool.

Quality Assessment of Ethics in Health Care: The Accountability Revolution

1994 ◽  
Vol 20 (1-2) ◽  
pp. 105-128
Author(s):  
Susan M. Wolf
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Quality Assessment ◽  
Central Place ◽  
World War ◽  
New Era ◽  
The Third ◽  
Cost Cutting ◽  
Global Budgeting

Writing in 1988, Arnold Relman heralded the dawning of the “third revolution“ in medical care. The first revolution, at the end of World War II, had inaugurated an Era of Expansion, with an explosion of hospitals, physicians, and research. Medicare and Medicaid were passed, and medicine experienced a golden age of growth. Inevitably, according to Relman, this yielded to an Era of Cost Containment starting in the 1970s. The federal government and private employers revolted against soaring costs, brandishing the weapons of prospective payment, managed care, and global budgeting. Yet these blunt instruments of cost-cutting eventually produced concern over how to evaluate the quality of health care, to promote the good while trimming the bad. Thus Relman announced the arrival of the Era of Assessment and Accountability.This chronology helps explain the current importance of quality. Quality assessment and more recently, quality improvement techniques, occupy a central place in this new era.

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