Political Economy of Reform under US Federalism: Adopting Single-Payer Health Coverage in New York State

Health Systems and Reform
Ashley M Fox, Yongjin Choi

Abstract

The US remains the only high-income country that lacks a universal health financing system and instead relies on a fragmented system with the largest segment of the population receiving health insurance through private, voluntary employer-sponsored health insurance plans. While not "universal" in the sense of being mandatory and tax-financed, through a series of reforms, the US has managed to provide some form of health insurance coverage to 90% of the population. Yet, the high cost of this system, the insufficient coverage afforded to many, and continued concerns about equity have led to calls for a national health insurance program that can reduce costs across the board while providing high-quality coverage for all. Given the policy gridlock at the national level, the states have often sought to achieve universal health financing on their own, but these bills have met with little success so far. Why has the ideal of states as "laboratories of democracy" failed to produce policy change towards national health insurance? This article examines the prospects for the New York Health Act, a single-payer bill that would create a universal health financing plan for all New York State residents. Applying the Political Economy of Healt...Continue Reading

References

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Jun 22, 2018·International Journal of Health Services : Planning, Administration, Evaluation·Ashley Fox, Roland Poirier

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Citations

Sep 24, 2019·Health Systems and Reform·Susan P SparkesMichael R Reich
Aug 16, 2019·Health Systems and Reform·Jeremy Shiffman

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