The Politics and Changing Political Economy of Health Care in the US and the UK

In the US, health care provision and potential reform of that provision has been a source of consistent controversy since at least the 1930s. There have been a series of set-piece political battles as different presidents have, with mixed success, attempted to reshape existing arrangements (Blumethal and Morone, 2010). In the UK, on the other hand, following the establishment of the National Health Service (NHS) in 1948, there was a period of relative policy stability. There were debates about how best to achieve the NHS’s goals but there was a period of ‘consolidation’ if not exactly fulfillment of the initial expectations for the service. That era of relative consensus ended in the late 1980s (Klein, 2006), and since then arguments over health care have continued in British political life. And in both the US and UK these ongoing arguments over health policy quickly took center stage with the changing of the partisan guard in Washington in 2009 and Westminster in 2010. This chapter, therefore, explores the problems faced by the incoming Obama and Cameron administrations with regard to health care policy and examines how, and how radically, they proposed to change existing arrangements in the US and UK respectively.