BiblioVault - Books about Policy Reform

Accountability

Patient Safety and Policy Reform

Virginia A. Sharpe, Editor

Georgetown University Press, 2004

According to a recent Institute of Medicine report, as many as 98,000 Americans die each year as a result of medical error—a figure higher than deaths from automobile accidents, breast cancer, or AIDS. That astounding number of fatalities does not include the number of those serious mistakes that are grievous and damaging but not fatal. Who can forget the tragic case of 17-year-old Jésica Santillán, who died after receiving a heart-lung transplant with an incompatible blood type? What can be done about this? What should be done? How can patients and their families regain a sense of trust in the hospitals and clinicians that care for them? Where do we even begin the discussion?

Accountability brings the issue to the table in response to the demand for patient safety and increased accountability regarding medical errors. In an interdisciplinary approach, Virginia Sharpe draws together the insights of patients and families who have suffered harm, institutional leaders galvanized to reform by tragic events in their own hospitals, philosophers, historians, and legal theorists. Many errors can be traced to flaws in complex systems of health care delivery, not flaws in individual performance. How then should we structure responsibility for medical mistakes so that justice for the injured can be achieved alongside the collection of information that can improve systems and prevent future error? Bringing together authoritative voices of family members, health care providers, and scholars—from such disciplines as medical history, economics, health policy, law, philosophy, and theology—this book examines how conventional structures of accountability in law and medical structure (structures paradoxically at odds with justice and safety) should be replaced by more ethically informed federal, state, and institutional policies. Accountability calls for public policy that creates not only systems capable of openness concerning safety and error—but policy that also delivers just compensation and honest and humane treatment to those patients and families who have suffered from harmful medical error.

[more]

Braking the Special Interests

Trucking Deregulation and the Politics of Policy Reform

Dorothy Robyn

University of Chicago Press, 1987

In 1980 Congress voted to eliminate the federal system of protective regulation over the powerful trucking industry, despite fierce opposition. This upset marked a rare example in American politics of diffuse public interests winning out over powerful economic lobbies. In Braking the Special Interests Dorothy Robyn draws upon firsthand observations of formal proceedings and behind-the-scenes maneuverings to illuminate the role of political strategy in the landmark trucking battle.

Robyn focuses her analysis on four elements of strategy responsible for the deregulator's victory—elements that are essential, she argues, to any successful policy battle against entrenched special interests: the effective use of economic data and analysis to make a strong case for the merits of reform; the formation and management of a diverse lobbying coalition of firms and interest groups; presidential bargaining to gain political leverage; and transition schemes to reduce uncertainty and cushion the blow to losers.

Drawing on political and economic theory, Braking the Special Interests is an immensely rich and readable study of political strategy and skill, with general insights relevant to current political battles surrounding trade, agriculture, and tax policies. Robyn's interdisciplinary work will be of great value to scholars and practitioners of politics, economics, and public policy.

[more]

The New Welfare Bureaucrats

Entanglements of Race, Class, and Policy Reform

Celeste Watkins-Hayes

University of Chicago Press, 2009

As the recession worsens, more and more Americans must turn to welfare to make ends meet. Once inside the agency, the newly jobless will face a bureaucracy that has undergone massive change since the advent of welfare reform in 1996. A behind-the-scenes look at bureaucracy’s human face, The New Welfare Bureaucrats is a compelling study of welfare officers and how they navigate the increasingly tangled political and emotional terrain of their jobs.

Celeste Watkins-Hayes here reveals how welfare reform engendered a shift in focus for caseworkers from simply providing monetary aid to the much more complex process of helping recipients find work. Now both more intimately involved in their clients’ lives and wielding greater power over their well-being, welfare officers’ racial, class, and professional identities have become increasingly important factors in their work. Based on the author’s extensive fieldwork in two very different communities in the northeast, The New Welfare Bureaucrats is a boon to anyone looking to understand the impact of the institutional and policy changes wrought by welfare reform as well as the subtle social dynamics that shape the way welfare is meted out at the individual level.

[more]

Policy Reform in American Agriculture

Analysis and Prognosis

David Orden, Robert Paarlberg, and Terry Roe

University of Chicago Press, 1999

Despite substantial transformations in American agriculture, farm program spending remains a closely guarded prerogative of United States agricultural policy. Policy Reform in American Agriculture examines both the history of farm subsidies and the contemporary relevance of traditional farm programs to today's agricultural industries.

This work analyzes the mixed performance of past agricultural support programs, reviews the current debate concerning farm policies, and critically assesses the often staunch political resistance to much-needed policy reforms. Casting a keen eye toward the most recent developments on both national and international fronts, the authors consider the ramifications of the 1996 Federal Agriculture Improvement and Reform (FAIR) Act as well as multilateral efforts to gain agricultural reform during the Uruguay Round of GATT. Their prognosis hinges upon both the continued growth and competitiveness of the world market and, perhaps more importantly, the ongoing commitment of congressional reform advocates.

[more]