A SOCIOHISTORICAL ANALYSIS OF THE ROLE OF INTEREST GROUPS IN SHAPING NATIONAL HEALTH INSURANCE REFORM (HEALTH INSURANCE INDUSTRY, HOSPITAL INDUSTRY, LABOR UNIONS, AMERICAN MEDICAN ASSOCIATION)

This dissertation explores the role employers, the health insurance industry, the hospital industry, labor unions and the American Medical Association played in preventing the enactment of national health insurance reform during 1987-1994.; In order to explore the role these groups played in shaping national health insurance reform, Bob Jessop's theory of the state (1982, 1990) as well as work done by health care scholars {dollar}{lcub}{dollar}e.g. Robert Alford (1975), Vicente Navarro (1976, 1986, 1993, 1994){dollar}{rcub}{dollar} were used to examine: (1) The conflicts likely to develop among employers, the health insurance industry, the hospital industry, physicians and labor unions regarding national health insurance reform. (2) Whether the conflict among private interests became transposed onto the conflict among political parties and the executive branch of government and prevented state actors from reaching agreement on national health insurance reform.; In order to explore these issues, an analysis was conducted of the congressional testimony of organizations representing the interests of employers, the health insurance industry, the hospital industry, labor unions and physicians during 1987-1994. Moreover, a detailed analysis was conducted of the health care bills advocated by Democrats, Republicans and the executive branch of government.; The evidence gathered supports Bob Jessop's assertion that the conflict among interest groups within a given policy domain frequently becomes transposed onto the conflict among political parties and the executive branch of government thereby leading to state inaction. It was found that the conflict among employers, the health insurance industry, the hospital industry, physicians and labor unions over national health insurance reform prevented Democrats, Republicans and the executive branch of government from reaching agreement on national health insurance reform. The findings of this dissertation also support Robert Alford (1975) and Vicente Navarro's (1976, 1986, 1993, 1994) assertions regarding the conflicts which typically prevent employers, the health insurance industry, the hospital industry, physicians and labor unions from reaching agreement on national health insurance reform.