Learning from the State? : federalism and national health policy
By: WEISSERT, Carol S
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Contributor(s): SCHELLER, Daniel.
Material type: 
ArticlePublisher: Malden, MA : Blackwell Publishers, December 2008Public administrarion review : PAR 68, Special, p. S162-S174Abstract: In its 1993 report, the Winter Commission gave direction to the federal government in the area of health policy and Medicaid: lead, follow, or get out of the way. This article examines how the federal government responded to that advice, specifically asking what has happened in the allocation of responsibility in health policies between 1993 and 2006. In short, unlike the suggestion that there be a better-defined direction in federalstate policy assignments in health, the ensuing years have resulted in more of the same. The authors examine what has happened, particularly focusing on vertical diffusionwhere the states have acted firstand on the role of policy learning in federal decision making. They find little recognition of policy learning in recent federal health lawseven in areas in which state experience was extensive. The federal government is leading in some health policiesbut it is leading without learning
In its 1993 report, the Winter Commission gave direction to the federal government in the area of health policy and Medicaid: lead, follow, or get out of the way. This article examines how the federal government responded to that advice, specifically asking what has happened in the allocation of responsibility in health policies between 1993 and 2006. In short, unlike the suggestion that there be a better-defined direction in federalstate policy assignments in health, the ensuing years have resulted in more of the same. The authors examine what has happened, particularly focusing on vertical diffusionwhere the states have acted firstand on the role of policy learning in federal decision making. They find little recognition of policy learning in recent federal health lawseven in areas in which state experience was extensive. The federal government is leading in some health policiesbut it is leading without learning
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