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Do Targeted Efforts for the Rural Underserved Help Kill Comprehensive Reform?
Author(s) -
Taylor Donald H.
Publication year - 1999
Publication title -
the journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.439
H-Index - 57
eISSN - 1748-0361
pISSN - 0890-765X
DOI - 10.1111/j.1748-0361.1999.tb00598.x
Subject(s) - opposition (politics) , poverty , remedial education , politics , political science , health reform , public administration , economic growth , medicine , public relations , health policy , health care , law , economics
There has been a shift during the past 60 years from a broad notion of the entire nation as underserved to a more focused effort to identify particular areas (often rural) thought to be underserved. This approach was formalized with the advent of the war on poverty. This focused approach has been cemented during the past 30 years, in part by the success of various federal health center programs that have remained funded during this period in spite of opposition. This paper concludes that the consensus view that rural underserved areas represent an “exception” phenomenon that is properly addressed with special responses (organizations or physicians) has had two major effects: (1) the political survivability of focused programmatic responses (such as Community Health Centers) has been enhanced; and (2) the existence of an “elastic net” policy network to advocate for the expansion of such remedial efforts may play a contributory role in helping to defeat comprehensive health reform.