POSC 343�Women - POSC 343Women, Healthcare, and...

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POSC 343—Women, Healthcare, and Politics M. Palley http://www.udel.edu/poscir/faculty/mPalley/mpalley.html February 11, 2009 *At the present time, according to Commerce Dept, 15% of nations GDP is associated with health care *The largest spender of healthcare is Government! *In 2007 47% of total bill was healthcare—35% was private—12% out of pocket-7.1% other private *In 2007 est. cost of healthcare $2.246 Trillion *Children largest part of welfare system—African American unwed Mothers —largest part The Policy Process(I) 1) The Nature of decision making in the US a. Incrementalism i. Hard to change that is quick ii. Prevent radical change b. Complexity of System i. Multiple access points ii. Need 60 votes to block a filibuster iii. Cant filibuster in the house iv. Then conference v. Then back to houses to decide vi. Then President vii.Then regulations within bureaucracy 2) Frame Issues a. Uses of symbols—choice vs life b. Use Data 3) Role of normative Values February 13, 2009
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The Policy Process(continued) Policy Initiation Problem definition Agenda Setting Policy Formulation-exec and judiciary Implementation— Federal’ State and Local Non-government Most law makers are non-elected Evaluation—complaince review—dauthorization—gov’t accountable II The actors Governmental— Non-governmenal: Insurance Doctors Clients Media Interest Groups Most research done at grassroots yet implementation takes place at top. February 16, 2009 History of Health Care system I. Historical Evolution —several perspectives—private institutions a. Doctors as independent businessmen b. Evolution of hospital system c. Evolution of government role in traditional non- governmental I I. Some early developments a. Med training b. Private practice: ideology; lassaiz-faire, f
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I I I. By 1920 health care services organized around IV. By 1945—Insurance a. Health ca February 20, 2009 History of Healthcare I. Medicare/Medicaid a. History b. Political Configuration—many AMA was opposed to Medicare—butunderstood the benefits and ran with it i. 1965 First government involvement with Health Care with medicare/Medicaid ii. 1947 Truman—supported some health insurance iii. 2/3 rd of American people supported national health insurance iv. Medicare= incremental step v. Hill Burton Act—support Building/hospitals vi. Kerr Mills Act-support the poor vii.Americans the strongest stakeholders viii. In 1950’s split ix. ANURSESA, AHA—in favor of medicare x. AMA-opposed to MEdicare xi. By 1960—population getting older—aging population begins to organize—more college graduates and education —living longer xii.Had an interesting Base of support xiii. Experts who were supporting healthcare for elderly xiv. By 1960’s—older=players xv.Became a campaign issue xvi. First televised debates 1. Nixon—social security
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2. Nixon Won-established Medicaid—took out kerr mills act 3. President responsible for was LB JOHNSON c. Health Conditions in US i. Prior to 1965—compared to industrialized world—horrific
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This note was uploaded on 03/15/2009 for the course POSC POSC343 taught by Professor Palley during the Spring '09 term at University of Delaware.

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POSC 343�Women - POSC 343Women, Healthcare, and...

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