Session Submission Summary
Share...

Direct link:

The Expansion of Health Policy and Public Health: Historical Perspectives

Thu, September 10, 10:00 to 11:30am MDT (10:00 to 11:30am MDT), TBA

Session Submission Type: Full Paper Panel

Session Description

By almost any tangible measure, the field of health policy has expanded dramatically over the past century or more. Not only has the field grown quantitatively in terms of cost, personnel, facilities and technology use, but the qualitative scope of health policy is also much wider with the inclusion of broad objectives like positive well-being and quality of life. This panel focuses on processes of expansion in the fields of health policy and public health, and mainly in a historical perspective.
The four papers in this panel offer a variety of cases and periods, but they share an interest in how political processes drive the expansion of health policy. While much scholarship has drawn on medicalization, professional power or political economy to explain the expansions of health care, too little attention has been given to ‘politics’ in this respect. Whether driven by the political struggle for power or by democratic mobilization of rights to health, the expansion of health is a political phenomenon that should not be understood as a simple effect of progress in medical technology. Similarly, it is important to discuss the policy feedback effects that may result from expanions of the health field.
The first paper by Grogan concerns the efforts to build an American national health system during and after the New Deal era, a process where proponents of a public role in health care hoped that a sort of policy feedback effect would ultimately exert itself on the popular acceptance of government in health policy. It demonstrates how the period did experience a substantial expansion or growth of public involvement in health, even if the hopes for comprehensive health insurance schemes were ultimately dashed after the war.
The second paper by Larsen also concerns efforts to expand the public role in health care during and after WWII. The boundaries of health policy were expanded through power struggles in both the domestic and the international domains, struggles that not only positioned actors strategically in times of change, but which also changed the dominant policy ideas about what health is and how it should be regulated politically. The paper shows how health became redefined as ‘wellbeing’ in the 1940s through a turf war between the WHO and the ILO, a struggle mirrored by the conflict about national health insurance in the United States.
The third paper by Sledge and Nachlis approaches the overall theme of expansion from the border between public health and drug control. The paper offers a detailed study of how methadone regulation emerged in the early 1970s. A new regulatory regime for methadone grew out of changing conceptions of opioids as a treatment rather than simply as criminal activity. The lasting effects of this regulatory change speak to the ongoing controversy over opioid use.
The final paper by Sullivan and Strach jumps back in time to analyze how regulatory regimes emerged and expanded in American cities around ‘the garbage problem’ in the late nineteenth and early twentieth centuries. This case also demonstrates how new (perceptions of) problems generated new regulatory regimes in public health, which again served to push the boundaries of health policy while also creating substantial corruption.

Sub Unit

Cosponsor

Individual Presentations

Chair

Discussants