The Convergence of Science and Governance: Research Health Policy and American States (review)

Although only 184 pages long, The Convergence of Science and Governance: Research Health Policy and American States is very powerful. It provides interrelated accounts about the evolution and convergence of health policy and politics in the United States. Daniel M. Fox, basing his account in part on his personal involvement, guides the reader through political and policy changes in the last century that influenced the present amalgamation of healthcare policy within the political arena. The emergence of special interest groups has predisposed the political powers to compete for their specialty interests in the fields of social justice, technology, health care policy, distribution of health care funds, and the increased accountability of healthcare professionals. The book outlines how politicians and state officials have used health care policy to maintain a high standard of efficacy in health care and improved health outcomes for populations struggling with the burden of disease and disability.

Fox argues that a convergence of science and government came about because of the recession in the spring of 2000 and the damaged reputation of pharmaceutical companies. States facing revenue shortfalls defied the power of the pharmaceutical companies and established policy from independent research to save money through generic drugs rather than name brands. The author indicates that with this evolution one sees policymakers become increasingly proficient in addressing health policy changed based on evidence-based research. The medically underserved benefit from strategic health care reform, newly having access to low-cost medications among other things.

Health care research and government policy converged in 2001 when many states began reviewing health care policy to inform evaluations of generic drugs for Medicaid programs. The author applauds the use of scientific research, analysis, and review to inform healthcare policy decision-making. Evidence-based scientific research advises policymakers' options. Transparency in policymaking ensures best practices evolve from sound scientific research for the benefit of the public and a reduction of risks that threaten the healthcare market. The author indicates that special interest groups continue to oppose convergence in their attempt to weaken or narrow the effect of convergence on health care policymakers.

The book consists of five chapter that guide the reader through the evolution of health care and government convergence, the reasons that convergence has advanced in recent years, the expansion of state government involvement in health policy decision-making, and a final discussion of the success of convergence and questions of sustainability. The book provides timely reflections on health care evolution and reform. The book is written for academics, but in an uncomplicated style that non-academics should find easy to follow. Another strength of the text is the extensive note section at the end of the book that provide the reader with the author's notes and an excellent overview of the reference sources from which the author supported his position.

The book should be part of any health care/political science program. The global conversation about health care has changed dramatically in the last 20 years and students of health care administration must understand this history. Post-graduate research students will benefit from the foundation this book provides in evidence-based research and best practices to inform health care policy.

I would recommend the book as part of the foundational curriculum in undergraduate and post-graduate studies. It provides a stepping stone for further research into how the scientific community can address the evolution of the culture of research and the convergence of healthcare within the political arena. It also provokes the question of how much government regulation and control should be allowed in scientific research. I thoroughly enjoyed the book as it challenges the status quo and moves the reader to question ongoing health care trends as they relate to underserviced populations.