Reforms at Risk

Reforms at Risk PDF

Author: Eric M. Patashnik

Publisher: Princeton University Press

Published: 2014-04-24

Total Pages: 254

ISBN-13: 1400828856

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Reforms at Risk is the first book to closely examine what happens to sweeping and seemingly successful policy reforms after they are passed. Most books focus on the politics of reform adoption, yet as Eric Patashnik shows here, the political struggle does not end when major reforms become enacted. Why do certain highly praised policy reforms endure while others are quietly reversed or eroded away? Patashnik peers into some of the most critical arenas of domestic-policy reform--including taxes, agricultural subsidies, airline deregulation, emissions trading, welfare state reform, and reform of government procurement--to identify the factors that enable reform measures to survive. He argues that the reforms that stick destroy an existing policy subsystem and reconfigure the political dynamic. Patashnik demonstrates that sustainable reforms create positive policy feedbacks, transform institutions, and often unleash the ''creative destructiveness'' of market forces. Reforms at Risk debunks the argument that reforms inevitably fail because Congress is prey to special interests, and the book provides a more realistic portrait of the possibilities and limits of positive change in American government. It is essential reading for scholars and practitioners of U.S. politics and public policy, offering practical lessons for anyone who wants to ensure that hard-fought reform victories survive.

Differential Diagnoses

Differential Diagnoses PDF

Author: Paul V. Dutton

Publisher: Cornell University Press

Published: 2012-11-09

Total Pages: 269

ISBN-13: 0801466407

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Although the United States spends 16 percent of its gross domestic product on health care, more than 46 million people have no insurance coverage, while one in four Americans report difficulty paying for medical care. Indeed, the U.S. health care system, despite being the most expensive health care system in the world, ranked thirty-seventh in a comprehensive World Health Organization report. With health care spending only expected to increase, Americans are again debating new ideas for expanding coverage and cutting costs. According to the historian Paul V. Dutton, Americans should look to France, whose health care system captured the World Health Organization's number-one spot. In Differential Diagnoses, Dutton debunks a common misconception among Americans that European health care systems are essentially similar to each other and vastly different from U.S. health care. In fact, the Americans and the French both distrust "socialized medicine." Both peoples cherish patient choice, independent physicians, medical practice freedoms, and private insurers in a qualitatively different way than the Canadians, the British, and many others. The United States and France have struggled with the same ideals of liberty and equality, but one country followed a path that led to universal health insurance; the other embraced private insurers and has only guaranteed coverage for the elderly and the very poor. How has France reconciled the competing ideals of individual liberty and social equality to assure universal coverage while protecting patient and practitioner freedoms? What can Americans learn from the French experience, and what can the French learn from the U.S. example? Differential Diagnoses answers these questions by comparing how employers, labor unions, insurers, political groups, the state, and medical professionals have shaped their nations' health care systems from the early years of the twentieth century to the present day.

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