Georgetown University Press

American Governance and Public Policy series

Gerard W. Boychuk, Karen Mossberger, and Mark C. Rom, Series Editors

Published by: Georgetown University Press


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American Governance and Public Policy series

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Interest Groups and Health Care Reform across the United States

Virginia Gray, David Lowery, and Jennifer K. Benz

Universal health care was on the national political agenda for nearly a hundred years until a comprehensive (but not universal) health care reform bill supported by President Obama passed in 2010. The most common explanation for the failure of past reform efforts is that special interests were continually able to block reform by lobbying lawmakers. Yet, beginning in the 1970s, accelerating with the failure of the Clinton health care plan, and continuing through the passage of the Affordable Care Act in 2010, health policy reform was alive and well at the state level.

Interest Groups and Health Care Reform across the United States assesses the impact of interest groups to determine if collectively they are capable of shaping policy in their own interests or whether they influence policy only at the margins. What can this tell us about the true power of interest groups in this policy arena? The fact that state governments took action in health policy in spite of opposing interests, where the national government could not, offers a compelling puzzle that will be of special interest to scholars and students of public policy, health policy, and state politics.

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Investing in the Disadvantaged

Assessing the Benefits and Costs of Social Policies

With budgets squeezed at every level of government, cost-benefit analysis (CBA) holds outstanding potential for assessing the efficiency of many programs. In this first book to address the application of CBA to social policy, experts examine ten of the mo

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Lessons of Disaster

Policy Change after Catastrophic Events

Thomas A. Birkland

Even before the wreckage of a disaster is cleared, one question is foremost in the minds of the public: "What can be done to prevent this from happening again?" Today, news media and policymakers often invoke the "lessons of September 11" and the "lessons of Hurricane Katrina." Certainly, these unexpected events heightened awareness about problems that might have contributed to or worsened the disasters, particularly about gaps in preparation. Inquiries and investigations are made that claim that "lessons" were "learned" from a disaster, leading us to assume that we will be more ready the next time a similar threat looms, and that our government will put in place measures to protect us. In Lessons of Disaster, Thomas Birkland takes a critical look at this assumption. We know that disasters play a role in setting policy agendas—in getting policymakers to think about problems—but does our government always take the next step and enact new legislation or regulations? To determine when and how a catastrophic event serves as a catalyst for true policy change, the author examines four categories of disasters: aviation security, homeland security, earthquakes, and hurricanes. He explores lessons learned from each, focusing on three types of policy change: change in the larger social construction of the issues surrounding the disaster; instrumental change, in which laws and regulations are made; and political change, in which alliances are created and shifted. Birkland argues that the type of disaster affects the types of lessons learned from it, and that certain conditions are necessary to translate awareness into new policy, including media attention, salience for a large portion of the public, the existence of advocacy groups for the issue, and the preexistence of policy ideas that can be drawn upon. This timely study concludes with a discussion of the interplay of multiple disasters, focusing on the initial government response to Hurricane Katrina and the negative effect the September 11 catastrophe seems to have had on reaction to that tragedy.

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Managing the Fiscal Metropolis

The Financial Policies, Practices, and Health of Suburban Municipalities

Rebecca M. Hendrick

Managing the Fiscal Metropolis: The Financial Policies, Practices, and Health of Suburban Municipalities is an important book. This first comprehensive analysis of the financial condition, management, and policy making of local governments in a metropolitan region offers local governments currently dealing with the Great Recession a better understanding of what affects them financially and how to operate with less revenue.

Hendrick’s groundbreaking study covers 264 Chicago suburban municipalities from the late 1990s to the present. In it she identifies and describes the primary factors and events that affect municipal financial decisions and financial conditions, explores the strategies these governments use to manage financial conditions and solve financial problems, and looks at the impact of contextual factors and stresses on government financial decisions. Managing the Fiscal Metropolis offers new evidence about the role of contextual factors— including other local governments—in the financial condition of municipalities and how municipal financial decisions and practices alter these effects. The wide economic and social diversity of the municipalities studied make its findings relevant on a national scale.

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Medicaid Politics

Federalism, Policy Durability, and Health Reform

Frank J. Thompson

Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise.

Many astute observers of the Medicaid debate have long claimed that “a program for the poor is a poor program” prone to erosion because it serves a stigmatized, politically weak clientele. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system.

In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.

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National Health Insurance in the United States and Canada

Race, Territory, and the Roots of Difference

After World War II, the United States and Canada, two countries that were very similar in many ways, struck out on radically divergent paths to public health insurance. Canada developed a universal single-payer system of national health care, while the Un

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Oil and Wilderness in Alaska

Natural Resources, Environmental Protection, and National Policy Dynamics

George J. Busenberg

Colliding environmental and development interests have shaped national policy reforms supporting both oil development and environmental protection in Alaska. Oil and Wilderness in Alaska examines three significant national policy reform efforts that came out of these conflicts: the development of the Trans-Alaska pipeline, the establishment of a vast system of protected natural areas through the Alaska National Interest Lands Conservation Act, and the reform of the environmental management of the marine oil trade in Alaska to reduce the risk of oil pollution after the Exxon Valdez disaster.

Illuminating the delicate balance and give-and-take between environmental and commercial interests, as well as larger issues shaping policy reforms, Busenberg applies a theoretical framework to examine the processes and consequences of these reforms at the state, national, and international levels. The author examines the enduring institutional legacies and policy consequences of each reform period, their consequences for environmental protection, and the national and international repercussions of reform efforts. The author concludes by describing the continuing policy conflicts concerning oil development and nature conservation in Alaska left unresolved by these reforms. Rich case descriptions illustrate the author's points and make this book an essential resource for professors and students interested in policies concerning Alaska, the Arctic, oil development, nature conservation, marine oil spills, the policy process, and policy theory.

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Out and Running

Gay and Lesbian Candidates, Elections, and Policy Representation

Donald P. Haider-Markel

Out and Running is the first systematic analysis of lesbian, gay, bisexual, and transgender (LGBT) political representation that explores the dynamics of state legislative campaigns and the influence of lesbian and gay legislators in the state policymaking process. By examining state legislative elections from 1992 to 2006 and state policymaking from 1992 to 2009, Donald Haider-Markel suggests that the LGBT community can overcome hurdles and win elections; and, once in office, these officials can play a critical role in the policy representation of the community.

However, he also discovers that there are limits to where and when LGBT candidates can run for office and that, while their presence in office often enhances policy representation, it can also create backlash. But even with some of these negative consequences, Out and Running provides compelling evidence that gays and lesbians are more likely to see beneficial legislation pass by increasing the number of LGBT state legislators. Indeed, grassroots politics in the states may allow the LGBT community its best opportunity for achieving its policy goals.

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The Politics of Ideas and the Spread of Enterprise Zones

Karen Mossberger

This book explores how policy ideas are spread—or diffused—in an age in which policymaking has become increasingly complex and specialized. Using the concept of enterprise zones as a case study in policy diffusion, Karen Mossberger compares the process of their adoption in Virginia, Indiana, Michigan, New York, and Massachusetts over a twelve-year period.

Enterprise zones were first proposed by the Reagan administration as a supply-side effort to reenergize inner cities, and they were eventually embraced by liberals and conservatives alike. They are a compelling example of a policy idea that spread and evolved rapidly. Mossberger describes the information networks and decisionmaking processes in the five states, assessing whether enterprise zones spread opportunistically, as a mere fad, or whether well-informed deliberation preceded their adoption.

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The Politics of Policy Change

Welfare, Medicare, and Social Security Reform in the United States

Daniel Béland; Alex Waddan

For generations, debating the expansion or contraction of the American welfare state has produced some of the nation's most heated legislative battles. Attempting social policy reform is both risky and complicated, especially when it involves dealing with powerful vested interests, sharp ideological disagreements, and a nervous public.

The Politics of Policy Change compares and contrasts recent developments in three major federal policy areas in the United States: welfare, Medicare, and Social Security. Daniel Béland and Alex Waddan argue that we should pay close attention to the role of ideas when explaining the motivations for, and obstacles to, policy change.

This insightful book concentrates on three cases of social policy reform (or attempted reform) that took place during the presidencies of Bill Clinton and George W. Bush. Béland and Waddan further employ their framework to help explain the meaning of the 2010 health insurance reform and other developments that have taken place during the Obama presidency. The result is a book that will improve our understanding of the politics of policy change in contemporary federal politics.

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