During the decade of the 1980s, the health sector of the United States underwent major political reordering. This political transformation followed on the heels of economic changes both within the health sector itself and the United States economy as a whole. The research investigates changes in the pattern of structural arrangements within the individual states during the period 1981 through 1987, within the context of national economic and political events. The central thesis is that alterations in the structural arrangements governing health care, as well as other societal sectors, emerge as a consequence of divergence of material interests within and among key elites having an economic interest in the operation of the sector. This divergence is seen to produce a fragmenting of prior political relations, the formation of new political alliances, and an opening of the public policy agenda to proposals for structural changes. The resulting policy outputs are expected to legitimate structural arrangements which more fully accommodate the interests of cohesive elites at the expense of those elites whose material interests are internally divided. / Through a combination of quantitative cross sectional analysis of all fifty states and case studies of selected states, the research demonstrates the extent to which varying conditions of political fragmentation or cohesion exhibited among health and non-health elites has led to the adoption of policies conducive to the transformation of market relations. The particular focus is upon policies affecting market relations between providers and purchasers of acute care hospital services. The three policies examined are: certificate of need regulation, hospital rate setting regulation, and mandatory hospital financial disclosure. / The results support the study's theoretic model. Where the interests of health elites appear to remain cohesive there is a strong bias toward the retention of market relations based primarily upon regulation. Conversely, where health elite interests appear to have fragmented there is a strong thrust toward market relations based primarily upon competition. Political cohesion among non health elites pushes market relations toward control over the flow of resources into the health sector either via price regulation or price negotiation depending respectively, upon whether health elite interests are cohesive or fragmented. / Source: Dissertation Abstracts International, Volume: 51-12, Section: A, page: 4297. / Major Professor: Allen W. Imershein. / Thesis (Ph.D.)--The Florida State University, 1990.
| Identifer | oai:union.ndltd.org:fsu.edu/oai:fsu.digital.flvc.org:fsu_78383 |
| Contributors | Rond, Philip C., III., Florida State University |
| Source Sets | Florida State University |
| Language | English |
| Detected Language | English |
| Type | Text |
| Format | 384 p. |
| Rights | On campus use only. |
| Relation | Dissertation Abstracts International |
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