National Health Insurance Policy in the United States: A Case of Non-Decision-Making

Abstract

Despite the vast range of commentaries and research on the current health care crisis, little research attention has been focused specifically on the lack of federal response to this crisis. As a way of focusing analysis on the specifics of Congressional inaction, it is suggested that both the range of health care proposals and the current debates in Congress my be seen as part of an ongoing bargaining process over legitimate alternatives for modification of health care delivery. It is argued that the lack of any new health care legislation may be seen as the result of a series of non-decisions by conservative Congressional representatives of the dominant medical interest groups. These non-decisions have successfully excluded any challenges to those interests by reliance upon a predominant “mobilization of bias” to effectively define and/or divert these challenges as illegitimate attempts at change. The changes which eventually evolve from Congressional compromise may represent a modification of the prevailing bias concerning legitimate alternatives, but are unlikely to modify the relation of the controlling interests involved.