The state and health care reform: the National Health Insurance and Public Health Act of 1949

Abstract

State-centered theory, elite theory, and the organizational state environment perspective have all been put forth to explain how policies come to be enacted in government and who benefits from such policy initiatives. It is proposed that the same forces affecting policy enactment can also prevent certain policies from being enacted. This study evaluates the capacity of these three theories to explain why the National Health Insurance and Public Health Act of 1949 was not enacted. This research includes an analysis of historical processes and environmental factors influencing this outcome. The findings indicate that there is very little support for state-centered theory. Limitations of the historical data limit the ability of this research to fully assess elite theory's capacity to explain the outcome. The organizational state environment perspective holds greater explanatory power in this case than either state-centered or elite theory.