Federalism and health policy
Federalism and health policy
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DOI：
10.1377/hlthaff.24.6.1458
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发表时间：
2005-11-01
期刊：
影响因子：
9.7
通讯作者：
Nathan, RP
中科院分区：
文献类型：
--
作者：
Nathan, RP
本文提出了美国联邦制和社会政策的周期性理论：许多社会政策倡议在州一级进行测试和完善，特别是在保守时期，后来演变为国家政策。本文描述了这样的联邦制周期，并提供了一个解释，为什么以及如何发生，重点是医疗补助。国家行动主义通过政策创新和抵制紧缩，特别是在保守时期，利用该计划提供的灵活性，保护和扩大了医疗补助。我的结论是，医疗补助的增量/伙伴关系的方法是适当的和可行的，以建立在未来扩大医疗保健覆盖面。
This paper presents a cyclical theory of U.S. federalism and social policy: Many social policy initiatives are tested and refined at the state level, especially during conservative periods, and later morph into national policies. The paper describes such federalism cycles and offers an interpretation of why and how they occur, focusing on Medicaid. State activism has preserved and expanded Medicaid through policy innovation and resistance to retrenchment, especially in conservative periods, by taking advantage of the flexibility the program provides. I conclude that Medicaid's incremental/partnership approach is appropriate and feasible to build on for a future expansion of health care coverage.