The United States remains the only industrialized nation that does not provide health care for all of its citizens. Several scholars have argued that no proposal for universal coverage will succeed without organized and sustained citizen mobilization on its behalf. Since the late 1980s, advocates have been organizing in the states in support of heath care for all. While there have been many reviews of the failures of advocates in the quest for universal coverage in the twentieth century, there has been little analysis of this emerging mobilization. As another window of opportunity for health reform may be approaching in the wake of the 2008 presidential election, the overall objectives of this study were (1) to assess the current state of advocacy for universal health care; and (2) analyze the extent to which existing state-based advocacy efforts provide the basis for an organized and sustained movement to build momentum for universal coverage at the national level.
The first step of this project was to conduct an organizational census to identify active state-based groups whose primary purpose was to advocate for universal coverage. The second phase included in-depth interviews with a purposive sample of advocates and foundations staff and participant observation. Additional sources of data included a substantial volume of email communication of movement organizations; organizational websites and documents; published books and articles by advocates, journalists, and scholars. Analysis of data was inductive and interpretive.
While there is widespread activism for universal coverage in states across the U.S., this activity has not yet developed into the organized, sustained mobilization with the ability to influence policy at the national level. This research has identified three overarching obstacles current advocacy efforts face in developing a national movement for universal health care: (1) lack of resources; (2) lack of organization and coordination; and (3) lack of an overarching vision about strategy and the larger political goal. Without a concerted effort to address these obstacles, advocates may not be able to take advantage of the next window of opportunity.
|Advisor:||Oliver, Thomas R.|
|School:||The Johns Hopkins University|
|School Location:||United States -- Maryland|
|Source:||DAI-B 69/04, Dissertation Abstracts International|
|Subjects:||Public health, Political science, Public policy, Health care management|
|Keywords:||Advocacy, National health insurance, Philanthropy, Social movement, Uninsured, Universal coverage, Universal health care coverage|
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