This dissertation examines the formation of health policy as a cultural process in a large federal bureaucracy in the United States, namely the Department of Veterans Affairs (VA). The everyday experience of bureaucrats working in the VA is used to answer the question: why does the VA fail to meet veterans’ needs in the face of a sacred trust, available political will, and robust resources? To answer the question, this project employs ethnographic methods that draw on participant observation at the headquarters office of the VA in Washington DC, archival research, and interviews with current and former VA employees during the Obama administration. I argue that care of veterans during post-war periods are critical moments of intervention that not only improved the population health of veterans but also impacted the ways in which America conceives and responds to health challenges. I also argue that when the VA operates at its best, it is often the leading edge of health reform, setting new standards for care and effectively establishing alternative models of care. Finally, my findings show that institutional factors play an important role in the process of health policy formation in ways that contribute to new understanding about causal conceptions of health. I conclude with a framework that draws on the lessons the VA affords, for health reform and advancing just health for all. / Anthropology
| Identifer | oai:union.ndltd.org:TEMPLE/oai:scholarshare.temple.edu:20.500.12613/551 |
| Date | January 2019 |
| Creators | Mandefro, Mehret |
| Contributors | Lazarus-Black, Mindie, Garcia-Sanchez, Inmaculada Ma. (Inmaculada Maria), Jhala, Jayasinhji, Wray, Matt, 1964- |
| Publisher | Temple University. Libraries |
| Source Sets | Temple University |
| Language | English |
| Detected Language | English |
| Type | Thesis/Dissertation, Text |
| Format | 285 pages |
| Rights | IN COPYRIGHT- This Rights Statement can be used for an Item that is in copyright. Using this statement implies that the organization making this Item available has determined that the Item is in copyright and either is the rights-holder, has obtained permission from the rights-holder(s) to make their Work(s) available, or makes the Item available under an exception or limitation to copyright (including Fair Use) that entitles it to make the Item available., http://rightsstatements.org/vocab/InC/1.0/ |
| Relation | http://dx.doi.org/10.34944/dspace/533, Theses and Dissertations |
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