An analysis of the reasons national health insurance failed to become policy in the United States.

摘要

The debate over a national health insurance system in the United States has recurred since the early 1900s. Perhaps no policy proposal has undergone more changes through time to accommodate the changing political environment than the creation of a national health insurance system. The reasons national health insurance proposals failed to become law in the United States have not been systematically studied.; This research began with the question, Why did national health insurance fail to become policy in the United States in the 1970s? Within that decade, there were three distinct periods of political debate on national health insurance: 1971, 1974 and 1979. Each period had a dominant proposal upon which the debate was focused: Senator Kennedy's Health Security Act of 1971; President Nixon's Comprehensive Health Insurance Plan in 1974; and President Carter's National Health Plan in 1979.; Over time, neither policy proposals nor political conditions remain the same. To make the examination between national health insurance proposals and the political environment methodical, a model was constructed. The premise of the model was that there are characteristics of policy proposals and political conditions which are associated with passage of a bill. The model served to make the assessment comparable across three proposals and three political time periods.; According to the research model, the time when political conditions were favorable to passage of a national health insurance proposal was in 1971. The underlying reason for the failure of national health insurance to become policy was that there were too few positive characteristics of proposals and political conditions present at the time of the debates.