front cover of Cries of Crisis
Cries of Crisis
Rethinking the Health Care Debate
Robert B. Hackey
University of Nevada Press, 2015
Since the late 1960s, health care in the United States has been described as a system in crisis. No matter their position, those seeking to improve the system have relied on the rhetoric of crisis to build support for their preferred remedies, to the point where the language and imagery of a health care crisis are now deeply embedded in contemporary politics and popular culture.

In Cries of Crisis, Robert B. Hackey analyzes media coverage, political speeches, films, and television shows to demonstrate the role that language and symbolism have played in framing the health care debate, shaping policy making, and influencing public perceptions of problems in the health care system. He demonstrates that the idea of crisis now means so many different things to so many different groups that it has ceased to have any shared meaning at all. He argues that the ceaseless talk of “crisis,” without a commonly accepted definition of that term, has actually impeded efforts to diagnose and treat the chronic problems plaguing the American health care system. Instead, he contends, reformers must embrace a new rhetorical strategy that links proposals to improve the system with deeply held American values like equality and fairness.
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Rethinking Health Care Policy
The New Politics of State Regulation
Robert B. Hackey
Georgetown University Press, 1998

States are increasingly important players in the current efforts to reform U.S. health care, as the federal government withdraws from this responsibility. Robert B. Hackey analyzes the varied routes states have taken in reformulating health care policy and provides a road map of what specific strategies work and why.

In this comparative case study, Hackey focuses on four states—Massachusetts, New Hampshire, New York and Rhode Island—that have had markedly different experiences with regulating health care over the past two decades. Hackey's detailed comparisons show how the states' policies changed over time, moving from regulatory to market-oriented solutions, and examines which policy programs appear best poised to meet the future.

Hackey uses regime theory to explain how the states' policy choices concerning cost control and entry regulation were shaped by the prevailing political culture and institution of each state. He concludes that the autonomy of state government form special interests is vital to the successful adoption, implementation and outcome of state initiatives.

Rethinking Health Care Policy offers policymakers, planners and specialists useful insights into the politics of state regulation and into future directions for health care reform.

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