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NATIONAL HEALTH INSURANCE: REVELATIONS IN CONGRESSIONAL TESTIMONY (HEARINGS, HEALTH CARE, VALUES, AMA, PROCOMPETITION)
Abstract
This thesis is an examination of the national debate over U.S. health care policy. It is more particularly an examination of the expression of that debate by national elites in the context of testimony and discussion before Senate and House committees of the 93rd, 96th, and 98th Congresses. National Health Insurance was close to enactment in 1974, but in 1984 seemed utterly removed from consideration. This transition, as revealed in the hearings documents, reflects major and signal change in the way policy-making elites view health, health care, and the role of government in health care provision. To measure the direction and terms of this change, a content analysis strategy is employed. Factors defining health care policy debate are developed by establishing a policy process framework to guide and inform a search for these factors in the relevant health care policy and Congressional studies literatures. Factors derived from the literature include: Societal Characteristics (the value/disvalue of government intervention and free enterprise, the prestige of the medical profession, etc.); Economic Conditions (cost impact on governmental and on personal budgets); Interest Group Activity (AFL-CIO support, For-Profit Hospitals support, etc.); Activity of Government Institutions (White House support, Congressional support, etc.); and Elite Behavior (health care cognoscenti, decision-makers). Changes in political position manifested by interest group, institutional,and elite actors are presented and discussed during the course of the analysis. The hearings records reveal that pressure for cost control, especially in terms of federal spending, worked a quantum change in the nature of NHI debate. Also figuring prominently in this change were factors expressing the value or disvalue of (1) government intervention, (2) health care free enterprise, (3) health care quality, and (4) health care equality. The author concludes that while NHI is not an active issue before the Congress in 1984, the U.S. health care system has undergone revolutionary structural change which greatly improves prospects for some form of NHI in the near future.
Subject Area
Political science
Recommended Citation
MACHADO, ARTHUR FRANCO, "NATIONAL HEALTH INSURANCE: REVELATIONS IN CONGRESSIONAL TESTIMONY (HEARINGS, HEALTH CARE, VALUES, AMA, PROCOMPETITION)" (1985). ETD collection for University of Nebraska-Lincoln. AAI8606965.
https://digitalcommons.unl.edu/dissertations/AAI8606965