As elected lawmakers confront complex social problems, they inevitably make choices to single out certain populations for government-sanctioned benefits or burdens. Why some groups and not others are targeted is the central question explored in this analysis of the congressional response to two related public health crises.
Weaving case studies from the wars against AIDS and drugs with an empirical analysis of fifteen years of congressional action on these issues, Mark Donovan shows how members of Congress balance problem solving with re-election concerns, paying particular attention to their need to craft compelling rationales for their actions. His analysis shows that, counterintuitive as it may seem, most target populations with negative public images are selected to receive benefits rather than burdens.
Demonstrating that it is possible to analyze simultaneously both policy rhetoric and policy outputs, this book shows how problem frames and policy decisions evolve through the dynamic interplay of conflict participants.
Within forty-eight hours after birth, the heel of every baby in the United States has been pricked and the blood sent for compulsory screening to detect or rule out a large number of disorders. Newborn screening is expanding rapidly, fueled by the prospect of saving lives. Yet many lives are also changed by it in ways not yet recognized.
Testing Baby is the first book to draw on parents’ experiences with newborn screening in order to examine its far-reaching sociological consequences. Rachel Grob’s cautionary tale also explores the powerful ways that parents’ narratives have shaped this emotionally charged policy arena. Newborn screening occurs almost always without parents’ consent and often without their knowledge or understanding, yet it has the power to alter such things as family dynamics at the household level, the context of parenting, the way we manage disease identity, and how parents’ interests are understood and solicited in policy debates.
Proposals to reform the health care system typically focus on either increasing private insurance or expanding government-sponsored plans. Guaranteeing that everyone is insured, however, does not create a system with the quality of care patients want, the flexibility clinicians need, and the internal dynamics to continually improve the value of health care.
In Total Cure, Hal Luft presents a comprehensive new proposal, SecureChoice, which does all that while providing affordable health insurance for every American. SecureChoice is a plan that restructures payment for medical care, harnessing the flexibility and responsiveness of the market by aligning the incentives of clinicians, hospitals, and insurers with those of the patient. It uses the accountability of government to ensure transparency, competition, and equity.
SecureChoice has two major components. A universal pool covers the major risks of hospitalization and chronic illness, which account for almost two-thirds of all costs. Everyone would be in the pool, irrespective of employment, income, or health status. The second component emphasizes choice, flexibility, and responsibility. People will be able to choose any physician to serve as their “medical home,” to keep track of their health records, provide much of their care, and suggest referrals. Clinicians will have the information and incentives to continually enhance quality. SecureChoice also facilitates improvements in areas ranging from malpractice to pharmaceuticals and establishes new roles for key stakeholders such as health insurers.
Based on the author’s fieldwork among the people of Zezuru, this study focuses on children as clients and as healers in training. In Reynolds’s ethnographic investigation of possession and healing, she pays particular attention to the way healers are identified and authenticated in communities, and how they are socialized in the use of medicinal plants, dreams, and ritual healing practices. Reynolds examines spiritual interpretation and remediation of children’s problems, including women’s roles in these activities, and the Zezuru concepts of trauma, evil, illness, and death. Because this study was undertaken just after the War of Liberation in Zimbabwe, it also documents the devastating effects of the war.
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