Health Care Reform: Policy Innovations at the State Level in the United States

This book examines the expanded role of state government in health policy innovation, explaining why some states are more likely than others to be innovative in the health care arena. The author provides detailed case studies of Oregon, Hawaii, and Oklahoma, states which have taken quite different paths in their search for increased access and reduced costs. A review of policy literature is presented, emphasizing the difficulty in using current theories to analyze health care reform efforts. The book also offers a unique comparative historical analysis of the emergence of modern health care systems in the United States, Canada, Germany, and Great Britain. A late starter in governmental involvement in health systems, the American federal government has provided health services to specific segments of the population through a series of incremental approaches such as Medicare, while more universal legislation has routinely been defeated. This combination of inaction by the federal government and rising costs has inspired the states to institute health reforms of their own. A highlight of this study is a ranking of all 50 states based on specific health policy innovations.