Health Reform and the Legal-Economic Nexus

An examination is made of the health system's litany of problems, including high costs, lack of access, inequality, and reform's repeated failure, in terms of institutionalist theory about the legal-economic nexus. Samuels (1989) defines the legal-economic nexus as the interaction of law a...

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Bibliographic Details
Published in:Journal of economic issues 1995-06, Vol.29 (2), p.639-649
Main Authors: Langbert, Mitchell, Murphy, Frederick
Format: Article
Language:English
Subjects:
Analysis
Economic theory
ECONOMICS
Employer provided health insurance
Failure analysis
Finance committees
HEALTH (ALSO SICKNESS AND DISEASE)
Health care costs
Health care expenditures
Health care policy
Health care reform
Health insurance
History
Insurance premiums
LAW AND LEGAL SYSTEMS
Medical policy
Medicare
National health insurance
Physicians
REFORM, REFORMERS
Reforms
Small businesses
Studies
STUDY OF HISTORY AS SUBJECT MATTER
Tax benefits
THEORY BUILDING OR THEORETICAL APPROACH
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Summary:An examination is made of the health system's litany of problems, including high costs, lack of access, inequality, and reform's repeated failure, in terms of institutionalist theory about the legal-economic nexus. Samuels (1989) defines the legal-economic nexus as the interaction of law and economy to distribute wealth among interests in accordance with a collective bargaining process that reflects history, custom, and ideology as well as economic power. It is argued that although President Clinton's 1993 health reform bill aimed to placate traditional health interests, its failure ensued from a fragmentation of power that evolved out of large corporations' and insurance companies' cost containment programs. These programs have shifted costs from large to small firms. In 1994, small business lobbies responded by stalling reform. However, corporate cost containment efforts themselves have responded to traditional health lobbies' earlier success in inhibiting reform; the system's evolution explains reform's failure.
ISSN:0021-3624
1946-326X
DOI:10.1080/00213624.1995.11505701