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Interests, Ideas, and Deregulation

The Fate of Hospital Rate Setting

This work studies the effectiveness of hospital rate setting as a mechanism for cost containment and details the economic and political factors leading to its demise in three of the four states examined. John E. McDonough brings his prior experience as Chair of the Health Care and Insurance Committees for the Massachusetts House of Representatives as well as a methodologically sound presentation to this topic. McDonough's unique vantage point serves as a clear asset in dissecting the events and lending perspective to the policymaking process. Which matters more in crafting public policy--the blunt force of interest groups and lobbyists or the development of new ideas that make a difference? Are elected officials leaders or followers in promoting policy change? McDonough answers these questions in the context of the complex world of health care and uses the thirty-year history of hospital rate setting as an example. The states covered in this volume are Massachusetts, New Jersey, New York, and Maryland. Characteristics of the subject states are provided in great detail along with case histories of rate setting in each. The book discusses the role of interest groups and policy ideas examining two rival models: The theory of economic regulation and the punctuated equilibrium model of policy change. Policymakers and administrators will be interested in how this work follows theory into practice and provides assistance in identifying obstacles in the creation and implementation of policy. Political scientists will be interested in its use of the punctuated equilibrium model of policy change, and economists concerned with the theory of economic regulation will be drawn to the discussion of it in the health care context. John E. McDonough is a Massachusetts State Representative, former Chair of the Health Care and Insurance Committees for that body, and Adjunct Professor of Health Policy, Boston University School of Medicine.

This work studies the effectiveness of hospital rate setting as a mechanism for cost containment and details the economic and political factors leading to its demise in three of the four states examined.

Inside National Health Reform

This indispensable guide to the Affordable Care Act, our new national health care law, lends an insider’s deep understanding of policy to a lively and absorbing account of the extraordinary—and extraordinarily ambitious—legislative effort to reform the nation’s health care system. Dr. John E. McDonough, DPH, a health policy expert who served as an advisor to the late Senator Edward Kennedy, provides a vivid picture of the intense effort required to bring this legislation into law. McDonough clearly explains the ACA’s inner workings, revealing the rich landscape of the issues, policies, and controversies embedded in the law yet unknown to most Americans. In his account of these historic events, McDonough takes us through the process from the 2008 presidential campaign to the moment in 2010 when President Obama signed the bill into law. At a time when the nation is taking a second look at the ACA, Inside National Health Reform provides the essential information for Americans to make informed judgments about this landmark law.

This indispensable guide to the Affordable Care Act, our new national health care law, lends an insider’s deep understanding of policy to a lively and absorbing account of the extraordinary—and extraordinarily ambitious—legislative ...

Experiencing Politics

A Legislator's Stories of Government and Health Care

John E. McDonough affords a rare glimpse into the practice of state politics in this insider's account of the fascinating interface between political science and real-life politics. A member of the Massachusetts House of Representatives for thirteen years and a skilled storyteller, McDonough eloquently weaves together stories of politics and policy with engaging theoretical models in a way that illuminates both the theory and the practice. By providing a link between scholarship and the world of experience, he communicates much about the essence of representative democracy. In the process, he demonstrates how politics extend beyond the public sphere into many aspects of life involving diverse values and interests. McDonough describes the nature of conflict, the role of interests, agenda setting, the nature and pace of change, the use of language, and more. Accessible, insightful, and original, his stories touch on a broad range of issues—including health care politics, campaigns, and elections; a street gang called the X-men; the death penalty; campaign finance reform, and tenants versus landlords. To the author, politics is everywhere and political dynamics are universal. While the setting for this book is one legislature, the lessons and insights are intended for everyone.

To the author, politics is everywhere and political dynamics are universal. While the setting for this book is one legislature, the lessons and insights are intended for everyone.