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The Role of the Private Sphere in US Healthcare Entitlements: Increased Spending, Weakened Public Mobilization, and Reduced Equity

The Role of the Private Sphere in US Healthcare Entitlements: Increased Spending, Weakened Public... Abstract The private sphere has always been an important component in US healthcare entitlements. Since the ACA further embeds the role of private actors, how private actors make claims on the state, and how the state reacts to these claims, becomes even more important, because such claims significantly shape US healthcare entitlements. The extent and increase of private benefits and contracting with private health plans is explicated for each healthcare entitlement program. The politics of how private inclusion shapes healthcare entitlements is examined with three main implications: it (1) creates a dominant discourse of health care deficits and spending crises; (2) submerges the role of government and may diminish mobilization for claiming entitlements; and (3) reduces equity in the distribution of costs and benefits. I conclude by highlighting that there are simple policy designs to address these problems, but the political dynamics of private inclusion will likely work against such policy logics. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Forum de Gruyter

The Role of the Private Sphere in US Healthcare Entitlements: Increased Spending, Weakened Public Mobilization, and Reduced Equity

The Forum , Volume 13 (1) – Apr 1, 2015

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Publisher
de Gruyter
Copyright
Copyright © 2015 by the
ISSN
2194-6183
eISSN
1540-8884
DOI
10.1515/for-2015-0007
Publisher site
See Article on Publisher Site

Abstract

Abstract The private sphere has always been an important component in US healthcare entitlements. Since the ACA further embeds the role of private actors, how private actors make claims on the state, and how the state reacts to these claims, becomes even more important, because such claims significantly shape US healthcare entitlements. The extent and increase of private benefits and contracting with private health plans is explicated for each healthcare entitlement program. The politics of how private inclusion shapes healthcare entitlements is examined with three main implications: it (1) creates a dominant discourse of health care deficits and spending crises; (2) submerges the role of government and may diminish mobilization for claiming entitlements; and (3) reduces equity in the distribution of costs and benefits. I conclude by highlighting that there are simple policy designs to address these problems, but the political dynamics of private inclusion will likely work against such policy logics.

Journal

The Forumde Gruyter

Published: Apr 1, 2015

References