Journal of Health Politics, Policy and Law 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Partisanship, Dysfunction, and Racial Fears: The New Normal in Health Care Policy?
Partisan politics snarled both the passage and the implementation of the Affordable Care Act (ACA). This essay examines partisanship's effects on health policy and asks whether the ACA experience was an exception or the new political normal. Partisanship itself has been essential for American democracy, but American institutions were not designed to handle its current form—ideologically pure, racially sorted, closely matched parties playing by "Gingrich rules" before a partisan media. The new partisanship injects three far-reaching changes into national health policy: an unprecedented lack of closure, a decline in th...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Morone, J. A. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Reform at the State and National Level Source Type: research
Implementing the Affordable Care Act: The Promise and Limits of Health Care Reform
The Obama administration has confronted a formidable array of obstacles in implementing the Affordable Care Act (ACA). The ACA has overcome those obstacles to substantially expand access to health insurance, though significant problems with its approach have emerged. What does the ACA's performance to date tell us about the possibilities and limits of health care reform in the United States? I identify key challenges in ACA implementation—the inherently disruptive nature of reform, partisan polarization, the limits of "near universal" coverage, complexity, and divided public opinion—and analyze how these issues...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Oberlander, J. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Reform at the State and National Level Source Type: research
Reform of the Individual Insurance Market in New Jersey: Lessons for the Affordable Care Act
The individual health insurance market has played a small but important role in providing coverage to those without access to group insurance or public programs. With implementation of the Affordable Care Act (ACA), the individual market has attained a more prominent role. However, achieving accessible and affordable coverage in this market is a long-standing challenge, in large part due to the threat of adverse risk selection. New Jersey pursued comprehensive reforms beginning in the 1990s to achieve a stable, accessible, and affordable individual market. We review how adverse risk selection can pose a challenge to achiev...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Cantor, J. C., Monheit, A. C. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Reform at the State and National Level Source Type: research
Medicaid Long-Term Care: State Variation and the Intergovernmental Lobby
This article advances knowledge of the origins, nature, and implications of this variation. After examining the degree of variation in state spending on Medicaid LTC, we show how federal policy has over the past fifty years steadily increased state discretion to shape these services. This decentralization largely reflects the potency of the intergovernmental lobby—governors and other state officials—in influencing federal policy. While fueling state variation, the intergovernmental lobby has also provided valuable political support that has helped Medicaid grow and resist retrenchment. After considering policy ...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Thompson, F. J., Cantor, J. C., Farnham, J. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Reform at the State and National Level Source Type: research
Opportunities and Challenges for Payment Reform: Observations from Massachusetts
Policy makers and private health plans are expanding their efforts to implement new payment models that will encourage providers to improve quality and deliver health care more efficiently. Over the past five years, payment reforms have progressed faster in Massachusetts than in any other state. The reasons include a major effort by Blue Cross Blue Shield of Massachusetts to implement global payment, the presence of large integrated systems willing to take on financial risk, and a supportive state policy environment. By 2014, thirty-seven percent of Massachusetts's residents enrolled in health plans were covered under risk...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Mechanic, R. E. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Reform at the State and National Level Source Type: research
Incomplete Markets and Imperfect Institutions: Some Challenges Posed by Trust for Contemporary Health Care and Health Policy
As contemporary health policy promotes evidence-based practices using targeted incentives, policy makers may lose track of vital aspects of care that are difficult to measure. For more than a half century, scholars have recognized that these latter aspects play a crucial role in high-quality care and equitable health system performance but depend on the potentially frail reed of providers' trustworthiness: that is, their commitment to facets and outcomes of care not easily assessed by external parties. More recently, early experience with pay for performance in health settings suggests that enhancing financial rewards for ...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Schlesinger, M., Gray, B. H. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Organization Source Type: research
Regulating and Paying for Hospice and Palliative Care: Reflections on the Medicare Hospice Benefit
Hospice began as a social movement outside of mainstream medicine with the goal of helping those dying alone and in unbearable pain in health care institutions. The National Hospice Study, undertaken to test whether hospice improved dying cancer patients' quality of life while saving Medicare money, found hospice care achieved comparable outcomes to traditional cancer care and was less costly as long as hospice lengths of stay were not too long. In 1982, before study results were final, Congress created a Medicare hospice benefit under a capitated per diem payment system restricting further treatment. In 1986 the benefit w...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Mor, V., Teno, J. M. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Organization Source Type: research
Evolving Concepts of Patient-Centered Care and the Assessment of Patient Care Experiences: Optimism and Opposition
In his seminal work on health care quality, Avedis Donabedian noted that patient satisfaction was a key indicator of health care quality, and in the 1970s and 1980s a great deal of research explored the determinants of patient satisfaction. Subsequently, attention shifted toward assessing care experiences, and there is now a large body of evidence related to the reliability and validity of survey-based assessments of care. As the use of such surveys has increased, so too have concerns about the validity and uses of such surveys. The available research, however, indicates that such surveys are reliable, valid, correlated ac...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Cleary, P. D. Tags: Health Policy & Education, Political Science, General, Public Policy Health Care Organization Source Type: research
Stigma as an Unrecognized Determinant of Population Health: Research and Policy Implications
Stigma processes play an underrecognized role in the distribution of life chances, influencing health through the production of disadvantage and the induction of stress. Policies enact stigma processes, mitigate them, or ignore them. If each of these two statements is correct, the intersection of stigma and policy demands our attention. We propose a change of perspective from an approach that considers one stigmatized status and one outcome at a time to a perspective that considers the full range of stigmatized statuses and outcomes so as to reveal stigma's full impact. Concerning the second statement, literature addressin...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Link, B., Hatzenbuehler, M. L. Tags: Health Policy & Education, Political Science, General, Public Policy Population Health Source Type: research
Needed Interventions to Reduce Racial/Ethnic Disparities in Health
This article addresses what is needed for social and behavioral interventions to be successful. We draw on important insights for reducing social inequalities in health that David Mechanic articulated more than a decade ago in his article "Disadvantage, Inequality, and Social Policy." We begin by outlining the challenge that interventions that have the potential to improve health at the population level can widen social inequalities in health. Next, given that there are racial differences in SES at every level of SES, we review research on race/ethnicity-related aspects of social experience that can contribute to racial in...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Williams, D. R., Purdie-Vaughns, V. Tags: Health Policy & Education, Political Science, General, Public Policy Population Health Source Type: research
Social Determinants and Disparities in Health: Their Crucifixion, Resurrection, and Ultimate Triumph(?) in Health Policy
David Mechanic has been a principal founder of modern sociological and social science approaches to health, especially in relation to health policy. These approaches have since the 1950s and 1960s resurrected ideas that had currency in the mid-nineteenth century but seemed crucified, dead, and buried by the rise of modern biomedicine from the mid-nineteenth century through the mid-twentieth century. Problems and lacunae in purely biomedical approaches to health in the later twentieth century, along with developments of new biopsychosocial approaches to health, have spawned a return toward ideas of Rudolf Virchow and mid-ni...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: House, J. S. Tags: Health Policy & Education, Political Science, General, Public Policy Population Health Source Type: research
Using the Courts to Shape Medicaid Policy: Olmstead v. L.C. by Zimring and Its Community Integration Legacy
In Olmstead v. L.C. by Zimring, the United States Supreme Court addressed the relationship between the Americans with Disabilities Act (ADA), a landmark in US civil rights law, and the Medicaid program. Olmstead holds that qualified individuals with disabilities who are protected by the ADA have the right to receive publicly funded services in community-integrated treatment settings and that medically unnecessary institutionalization violates the ADA. But the Court had to wrestle with the extent to which the ADA requires state Medicaid programs to make deep and structural reforms in how long-term care services are organize...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Rosenbaum, S. Tags: Health Policy & Education, Political Science, General, Public Policy Mental Health and Mental Health Policy Source Type: research
The Rise of Primary Care Physicians in the Provision of US Mental Health Care
Primary care physicians have assumed an increasingly important role in US outpatient mental health care. They are providing an increasing volume of outpatient mental health services, prescribing a growing number and variety of psychotropic medications, and treating patients with a broader array of mental health conditions. These trends, which run counter to a general trend toward specialization and subspecialization within US health care, place new strains on the clinical competencies of primary care physicians. They also underscore the importance of implementing more effective models of collaboration between primary care ...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Olfson, M. Tags: Health Policy & Education, Political Science, General, Public Policy Mental Health and Mental Health Policy Source Type: research
Economics and the Transformation of the Mental Health System
Mental illnesses provide a difficult set of challenges to American health and social institutions. Those challenges have been a continuous concern of David Mechanic's over the course of his career. In this article we trace the development of modern economic and organizational structures that drive the delivery of mental health care in the early part of the twenty-first century. We show how the nature of mental disorders themselves and the treatment for addressing those illnesses pose fundamental difficulties to health care organizational and financing structures. We analyze the factors that have caused the dramatic changes...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Glied, S., Frank, R. G. Tags: Health Policy & Education, Political Science, General, Public Policy Mental Health and Mental Health Policy Source Type: research
The Troubled History of Psychiatry's Quest for Specificity
Over the course of the nineteenth century, medical disciplines replaced holistic conceptions of body and mind with specific diagnoses that were unrelated to the qualities and circumstances of the individuals who harbored them. Despite periodic attempts from the late nineteenth through the mid-twentieth centuries to implement diagnostic systems based on the principle of specificity, psychiatric diagnoses remained undifferentiated, overlapping, and capacious. The need for medical legitimacy, compatibility with a biomedical model, and conditions that third parties would reimburse led psychiatry to replace the psychodynamicall...
Source: Journal of Health Politics, Policy and Law - August 8, 2016 Category: Health Management Authors: Horwitz, A. V., Grob, G. N. Tags: Health Policy & Education, Political Science, General, Public Policy Mental Health and Mental Health Policy Source Type: research
