LE3 .A278 2017

2017

Brickner, Rachel

Acadia University

Bachelor of Arts

Honours

Politics

Politics

Historically, health care in the United States has followed a privatized and employer-based path. However, there have been moments of legislative debate that have called into question the effectiveness of this system to provide accessible, affordable, and quality health care to all citizens. Why is the U.S. one of the only developed countries without a national policy to ensure universal health coverage? To answer this research question, I use a historical institutionalism approach with a temporal within case study analysis of critical juncture periods. From this case study analysis, I found that path dependency theory can be used to explain the lack of universal health care in the U.S. and that the tool of critical junctures can be used to explain a shift in health care policy in the post-World War II period. The health care institution has remained on a static path primarily due to the congressional makeup and opposition group mobilization during these periods of contestation. There was a shift in the privatized path of health care with the passage of the Patient Protection and Affordable Care Act in 2010, marking a change that included government involvement with health care coverage and costs of everyday U.S. citizens. In 2017, the threat of repeal from the Trump administration marks a new critical juncture period, where the administration could pay the high political costs of reversing the decisions made in 2010, but the possible repeal would also follow the rhetoric of past health care decisions, which broadly kept health care out of the hands of the federal government.

The author retains copyright in this thesis. Any substantial copying or any other actions that exceed fair dealing or other exceptions in the Copyright Act require the permission of the author.

https://scholar.acadiau.ca/islandora/object/theses:2123