Talk:Health care reform

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This is the talk page for discussing improvements to the Health care reform article.
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[edit] This

This entire series of articles on health care reform appears to be a series of advocacy papers written from a left-liberal perspective. In particular, the articles about health care reform between the teens and forties, health care reform under Truman, health care reform under Nixon, health care reform under Carter, and health care reform under Clinton are all written from a point of view that clearly favors some sort of national single-payer or modified single-payer system. The author considers setbacks for increased state control of health care "unfortunate" at nearly every juncture.

While they contain valuable historical information, they need to be edited to conform to the NPOV policy. The coverage itself also violates the spirit of the NPOV policy: presidents George H.W. Bush and George W. Bush also proposed major health care system reforms which would emphasize market mechanisms and individual responsibility. They are currently are not covered at all. I have tagged all of them with a NPOV and quality tags. Since it seems clear that one person wrote all these articles--I'm including notes on all the talk pages to discuss the issues here.

Elirl

Anyone who read the history for these pages would quickly see they were not at all written by a single author. This material was posted by members in my Politics of Health Care class taught at Duke University. They use a common template in terms of how the information is "packaged" so that it's relatively to look across these "case studies" and see a common set of questions being addressed. Our focus in class was universal coverage proposals and the "puzzle" we were addressing is why such initiatives repeatedly have been defeated over nearly 100 years of effort given that public opinion polls repeatedly show overwhelming support for the idea of universal coverage. We did not have time in class to look at every administration or every set of proposals that has ever been advanced. Those wishing to post "case studies" of health reform efforts by Bush 41 or Bush 43 are more than welcome to do so.

FWIW, I am very far from being an advocate of single payer: indeed, I presented (to rather considerable ridicule) a paper at the American Political Science Association convention last September a paper titled How the U.S. Achieved Universal Coverage under George W. Bush, outlining a very market-oriented approach to universal coverage entailing an individual mandate coupled with high-deductible consumer-directed health plans. This style of reform has been championed in books published by American Enterprise Institute, Heritage Foundation and other market-oriented think tanks or writers, hardly champions of a single payer approach. I continue to believe that if we get universal coverage, it is far more likely to emerge through leadership from a Republican president using a platform that is market-oriented rather than single payer. Moreover, I think one could legitimately view the history of failed efforts to achieve universal coverage and make the case that it was the repeated dogmatic refusal of single payer advocates to compromise on their vision of what universal coverage should look like that has led us into the impasse we face even today.

Thus, if you detect bias in these cases, you can rest assured it was not encouraged by me. On the contrary, I repeatedly made clear that I expected these students fleshing out these cases to stick to reporting on the facts in each case: who did what, when, why and how, etc. as opposed to getting into philosophical discussions of the ethical merits of one approach to universal coverage versus another. I thought that sharing our collective class work on Wikipedia made far more sense than just creating these cases for our own use and thereafter consigned to the dustbin of academia. You may regard our focus on universal coverage as biased in and of itself, but as indicated above, it is the disconnect between repeated expressions of public opinion and our failure to address these that creates the puzzle. Were only 25% of the public in favor of universal coverage, there would be no puzzle to solve and not much interest in cases to help us better understand why this idea keeps failing.

Thus, if you believe there are certain expressions of bias within a given case, then the appropriate corrective is to simply make the requisite edit(s) as opposed to branding the entire page as being biased. I think any even-handed observer would conclude that 95% or more of the content is strictly factual. If occasional expressions of a less-than-neutral point of view crept in, it was not my intent; in the real world, neither my students nor the men's or women's basketball teams are perfect. That said, in my classes, 95% is A work. Armed with more perfect information than s/he may have had when applying the NPOV and quality tags to this work, I would encourage Elirl to consider their removal.

--Conoverc 16:51, 7 February 2006 (UTC)

[edit] Lots of changes to this page needed...

The distinction between "health reform" and "health care reform" is very artificial. It would be best to combine the two into a more comprehensive article on both the political processes and the management practices surrounding planning for change in health systems. It should be an international account - the history of health reform in the US has rightly been moved to other pages. 85.210.43.69 01:24, 13 May 2006 (UTC)(stuartjcameron).

[edit] Merge

These two articles have mostly different content, but the basic subject is the same. I think they would both be stronger if someone merged the content into a single article. WhatamIdoing (talk) 00:24, 22 January 2008 (UTC)

It strikes me that a large portion of the Health care politics article has more in common with the article on Universal health care than it does with this one - for example, the discussion of philosophy and the arguments for and against socialized medicine. Do a word search on "universal health care" in the article - you'll be amazed at how many hits you get. I'd suggest merging it with the universal health care article instead. I don't see that the politics article adds much to the combination of the Universal health care, Health care reform, Health policy analysis and Health economics articles. Perhaps it would help to have a separate "politics" article if it focused more on how different political systems address health care, why they result in different solutions, or how different interest groups engage the issue politically - but that doesn't seem to be the direction it has taken. —Preceding unsigned comment added by EastTN (talk • contribs) 19:10, 22 January 2008 (UTC)
As I have stated in other discussions, I think there's a distinction between articles that are at least making an attempt at a global approach to the issue, and those that are clearly focused on the United States. To me, health care reform is a global issue, and so far the content here reflects an attempt to address it globally. On the other hand, the article on health care politics reflects primarily the debate in the United States. I have suggested elsewhere that the debate in the United States needs to be the subject of its own article, and that the debate sections that focus primarily on these issues in the United States (see the two-column table at the bottom of universal health care and the lengthy section in publicly funded health care should come out of more global articles and be moved to a U.S. specific article. I agree that the health care politics article is a mess as it stands. Perhaps the article could be called "Health care reform in the United States". Any support for that idea? --Sfmammamia (talk) 21:19, 26 February 2008 (UTC)
Sure - I don't know what the best way is to bring order to all this, but that suggestion sounds reasonable to me.EastTN (talk) 14:50, 27 February 2008 (UTC)
I've just noticed that there's also an article on National health insurance. I can't get my head around how all of these articles fit together: Universal health care; Publicly-funded health care; Single-payer health care; National health insurance; Socialized medicine; and Social health insurance (what am I missing?). I know there are real conceptual distinctions between at least some of these, and different people use these terms in different contexts, but what we've got right now is terribly confusing. It would really help if someone could come up with a reasonable taxonomy for these different terms and build at least a short umbrella article that would set some context for how to distinguish between them, and bring together links to all of them in a way that would help readers understand how they relate to each other.EastTN (talk) 20:26, 29 February 2008 (UTC)
If we were to do this - rename the health care politics article "Health care reform in the United States" - which sections would we pull out of the other articles to populate it? The "Debate in the United States" section of Universal health care; the "Debate" section of Publicly-funded health care; the "Proponents and intent," "Opponents and criticisms," "Polls," and "State proposals" sections of Single-payer health care; the "2008 U.S. Presidential election" section of Socialized medicine? Anything else?EastTN (talk) 18:18, 10 March 2008 (UTC)

I would support the creation of an article "Health care reform in the United States". It is clear that there is going to be reform and it would indeed be very helpful keep all the arguments and issues about reform in the U.S. in an article that is specific to that country. We should then try to eliminate all the U.S. centric arguments about health care funding, regulation etc.. from the general sections in articles such as Universal health Care, Health Insurance, socialized medicine and publicly-funded health care and keep these in specific sections dedicated to that country. These latter articles are global in nature and should not be dominated all the time by US political arguments. I don't agree with the idea that "health care reform is a global issue" expressed above. No country has a static health care system and reform is ongoing but different countries will have different issues and different start points. Thus what works for one country may not work for another and reform can be heading in different directions in different countries.Thus we should have articles describing various types of systems around the world and the pros and cons of each. But the big issue of reform in the U.S. should be in a U.S. specific article.--Tom (talk) 08:39, 13 March 2008 (UTC)

I've taken a first stab at creating a Health care reform in the United States article. I've tried to pull together all the material we've discussed, and done a very rudimentary job of weaving it together. I have not attempted to remove the material from other articles, nor to add links to the new article. Please take a look to see if all the appropriate material has been moved into it. If so, perhaps we can start cleaning up the other articles a bit.EastTN (talk) 20:17, 21 March 2008 (UTC)