Journal of health politics, policy and law
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J Health Polit Policy Law · Oct 2021
Compounding Racialized Vulnerability: COVID-19 in Prisons, Jails, and Migrant Detention Centers.
Carceral institutions are among the largest clusters of COVID-19 in the United States. In response, activists and detainees have rallied around decarceration demands: the release of detainees and inmates to prevent exposure to COVID-19. This article theorizes the compounding racial vulnerability that has led to such a marked spread behind bars, mainly among race-class subjugated (RCS) communities. ⋯ The conditions in carceral institutions during the pandemic-and public opinion about them-highlight the realities of compounding racialized vulnerability in the United States.
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J Health Polit Policy Law · Sep 2021
The Political Realignment of Health: How Partisan Power Shaped Infant Health in the U.S., 1915-2017.
The U. S. two-party system was transformed in the 1960s, when the Democratic Party abandoned its Jim Crow protectionism to incorporate the policy agenda fostered by the Civil Rights Movement and the Republican Party redirected its platform toward socioeconomic and racial conservatism. We argue that the policy agendas that the parties promote through presidents and state legislatures codify a racially patterned access to resources and power detrimental to the health of all. ⋯ Net of trend, overall, and race-specific infant mortality rates were not statistically different between presidential parties before the Political Realignment. This pattern, however, changed after the Political Realignment, with Republican administrations consistently underperforming Democratic ones. Net of trend, non-Southern state legislatures controlled by Republicans underperform Democratic ones in overall and racial IMRs in both periods.
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J Health Polit Policy Law · Aug 2021
Fighting for America's Paradise-the Struggle against Structural Racism.
Structural racism is a fundamental cause of racial inequities in health in the United States. Structural racism is manifested in inequality in the criminal justice system; de facto segregation in education, health care, and housing; and ineffective and disproportionately violent policing and economic disenfranchisement in communities of color. ⋯ The United States is now in an unprecedented moment in its history with a new administration that explicitly states, "The moment has come for our nation to deal with systemic racism . . . and to deal with the denial of the promise of this nation-to so many." The opportunities for creating innovative and bold policy must reflect the urgency of the moment and seek to dismantle the systems of oppression that have for far too long left the American promise unfulfilled. The policy suggestions made by the authors of this article speak to the structural targets needed for dismantling some of the many manifestations of structural racism so as to achieve health equity.
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J Health Polit Policy Law · Aug 2021
Medicare's Stewardship Role to Improve Care Delivery: Opportunities for the Biden Administration.
Medicare initiatives have been instrumental in improving care delivery and payment as exemplified by its role in broadly expanding the use of telehealth during the COVID-19 pandemic. Medicare innovations have been adopted or adapted in Medicaid and by private payers, while Medicare Advantage plans successfully compete with traditional Medicare only because their payment rates are tied by regulation to those in the traditional Medicare program. ⋯ It is increasingly clear that burdensome attention to measurement and reporting distracts from what could be successful efforts to actually improve care through quality improvement programs, with Medicare leading in partnership with providers, other payers, and patients. Although Congress is unlikely to adopt President Biden's proposals to decrease the eligibility age for Medicare or to adopt a public option based on Medicare prices and payment methods in the marketplaces, the Biden administration has an opportunity to provide overdue, strategic direction to the pursuit of value-based payments and to replace failed pay-for-performance with provider-managed projects to improve quality and reduce health disparities.
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J Health Polit Policy Law · Feb 2021
Health "Brexternalities": The Brexit Effect on Health and Health Care outside the United Kingdom.
The principal effects of Brexit on health and health care will fall within the United Kingdom, and all forms of Brexit have overwhelmingly negative implications for health care and health within the UK. This article focuses on the external effects of Brexit ("Brexternalities") for health and health care. The EU is a particularly powerful institutional and legal arrangement for managing economic and political externalities in health policy as in any other policy. ⋯ They are felt more distinctly in the context of those elements of health policy that are most closely entwined with the UK's health policy (e.g., on the island of Ireland, certain areas of Spain, and other parts of southern Europe). Some health Brexternalities, such as in medicine safety, will be imposed on the whole population of the EU. And some health Brexternalities, such as communicable disease control, will be felt globally.