Learning from defeat? Political analysis and the failure of health care reform in the United States
By: HACKER, Jacob S
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Material type: 
ArticlePublisher: 2001British Journal of political science 31, 1, p. 61-94Abstract: The demise of President Clinton`s 1993 health care reform plan provides a revealing window into the difficulties and hazards of drawning lessons from complex political events. In an effort to identify the causes and implications of the Clinton plan`s failure, students of American health policy have offered a bizzard of alleged historical lessons that purport to explain why the plan, along with its leading alternatives, went down to such a crushing politcal defeat.On closer inspection, however, many of these putative lessons turn out to be hastiliy formulated, weakly grounded and prescriptively inadequate. These deificencie are by no means unique to the commentary on health care reform in the United states. Rather, they reflect, general risks of constructing lessons for action or analysis on the basis of just one or a few striking political events. Although these risks are endemic to historical lesson-drawring, they could be reduced by more careful attention to basic rules of historical comparison and counterfactual analysis. They could also be mitigated by a freater awareness of the fundamental uncertainties that, for a variety reasons, caracterize complex political interactions. Viewing outcomes as uncertain does not preclude forecasting and, indeed, may lead to more nuanced and accurate predictions ,as well asto greater appreciationof historical turning points and momoents of meaningful strategic choice
| Item type | Current location | Collection | Call number | Status | Date due | Barcode |
|---|---|---|---|---|---|---|
| Periódico | Biblioteca Graciliano Ramos | Periódico | Not for loan |
The demise of President Clinton`s 1993 health care reform plan provides a revealing window into the difficulties and hazards of drawning lessons from complex political events. In an effort to identify the causes and implications of the Clinton plan`s failure, students of American health policy have offered a bizzard of alleged historical lessons that purport to explain why the plan, along with its leading alternatives, went down to such a crushing politcal defeat.On closer inspection, however, many of these putative lessons turn out to be hastiliy formulated, weakly grounded and prescriptively inadequate. These deificencie are by no means unique to the commentary on health care reform in the United states. Rather, they reflect, general risks of constructing lessons for action or analysis on the basis of just one or a few striking political events. Although these risks are endemic to historical lesson-drawring, they could be reduced by more careful attention to basic rules of historical comparison and counterfactual analysis. They could also be mitigated by a freater awareness of the fundamental uncertainties that, for a variety reasons, caracterize complex political interactions. Viewing outcomes as uncertain does not preclude forecasting and, indeed, may lead to more nuanced and accurate predictions ,as well asto greater appreciationof historical turning points and momoents of meaningful strategic choice
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