Health care reform and state U.S. regional policy

One of the reasons of social contradictions aggravation in modern USA is inequality of provision of the population with medical benefits, which actualizes the research of reforms and directions of regional policy, carried out by the state in the sphere of health care. The purpose of the research consists in revealing the tendency of formation of inequality in provision of the population of the USA with medical services, developed as a consequence of socio-economic and political processes in American society, expressed in permanent reforming of national health care and state regulation of regional problems. On the basis of the evolutional-genetic approach to the subject of research and the use of methods of statistical and economic analysis, as well as abstract-logical methods of processing of the theoretical material the results were obtained, that reflect the dynamics of the studied inequality and the factors determining it during 1951—2020 years were revealed. A number of conclusions reflecting the spatial-temporal and socio-structural nature of inequality in the provision of medical benefits to the US population, determined by the economic and political cyclism of the development of American society in the period under study, are made. The consequence of cyclicity is the inconsistency of reforming and using various types of state regional policy in the regulation of healthcare, depending on conjunctural factors. 

1. Vsemirnyi den' zdorov'ya 2021 g. Postroim bolee spravedlivyi, bolee zdorovyi mir [World Health Day 2021: building a healthier, more fair world], Vsemirnaya organizatsiya zdravookhraneniya [World health organization], [ofits. cait]. Available at: https://www.who.int/ru/campaigns/world-health-day/2021 (accessed: 11.08.22).

2. Gruber J. Healthcare Reform: what it is, why it’s necessary? Illustrated by N. Schreiber. New York, 2011, 152 p.

3. Smith J.C., Medalia C. Health Insurance Coverage in the United States: 2014, Current Population Reports. U. S. Census Bureau, September 2015, 142 p.

4. Sommers B.D., Baicker K., Epstein A.M. Mortality and Access to Care among Adults after State Medicaid Expansions. Boston. Harvard School of Public Health, NEJM, 2012, 316 p.

5. Korotina N.Yu. Formirovanie teoreticheskoi modeli ekonomicheskogo federalizma na osnove dvoistvennoi sushchnosti gosudarstva [Formation of a theoretical model of economic federalism based on the dual essence of the state], Federalizm [Federalism], 2021, vol. 26, no. 4 (104), pp. 75—88. DOI: 10.21686/2073-1051-2021-4-75-88.

6. Ustinovich E.S. Voprosy operatsionnogo opredeleniya kategorii “gosudarstvennaya regional'naya ekonomicheskaya politika” i “regional'naya ekonomicheskaya politika” v sovremennoi politicheskoi nauke [Issues of operational definition of the categories of “state regional economic policy” and “regional economic policy” in contemporary political science], Izvestiya Yugo-Zapadnogo gos. un-ta. Ser.: Istoriya i pravo [Izvestia of the South-Western State University. Ser.: History and Law], 2020, vol. 10, no. 3, pp. 63—69.

7. Odintsova A.V. Ot strategicheskogo planirovaniya k territorial'noi rezilientnosti [From strategic planning to territorial resilience], Federalizm [Federalism], 2020, vol. 25, no. 4 (100), pp. 26—41. DOI: 10.21686/2073-1051-2020-4-26-41.

8. Davydov A.Yu. Ekonomicheskii tsikl SShA v usloviyakh pandemii [The U.S. economic cycle in a pandemic], SShA & Kanada: Ekonomika — politika — kul'tura [USA & Canada: economy - politics - culture], 2021, Issue 8, pp. 5—18. DOI: 10.31857/S268667300016019-0.

9. Minat V.N. Dinamika prostranstvennogo neravenstva v razvitii zdravookhraneniya SShA i gosudarstvennaya regional'naya politika [The dynamics of spatial disparities in U.S. health care and regional public policy], Federalizm [Federalizm], 2022, vol. 27, no. 1 (105), pp. 130—149. DOI: 10.21686/2073-1051-2022-1-130-149.

10. Burdzhalov F. Reforma zdravookhraneniya v SShA (sotsial'no-ekonomicheskie aspekty) [Health care reform in the United States (Social and economic aspects)], Mirovaya ekonomika i mezhdunarodnye otnosheniya [World economy and international relations], 2010, no. 10. pp. 44—55. DOI:10.20542/0131-2227-2010-10-44-55.

11. Kostyaev S.S. Mezhpravitel'stvennoe lobbi, mezhbyudzhetnye batalii i reforma zdravookhraneniya v SShA [The intergovernmental lobby, budget battles, and health care reform in the U.S.], SShA & Kanada: Ekonomika — politika — kul'tura [USA & Canada: economy - politics - culture 2014], 2014, no. 12 (540), pp. 37—52.

12. Leonov S.N., Sidorenko O.V. Selektivnaya regional'naya politika kak samostoyatel'nyi tip regional'noi politiki gosudarstva [Selective regional policy as an independent type of regional policy of the state], Gosudarstvennoe upravlenie [Public administration], 2011, Issue 28, pp. 11—16.

13. Stroeva O.A., Kvak A.A. Instrumentarii realizatsii regional'noi innovatsionnoi politiki proaktivnogo kharaktera [Instruments of implementation of regional innovation policy of a proactive nature], Srednerusskii vestnik obshchestvennykh nauk [The Mid-Russian Vestnik of social sciences], 2014, no. 6 (36), pp. 102—109.

14. U. S. Department of Health and Human Services. Programs and services. Available at: https://www.hhs.gov/about/budget/fy2022/index.html (accessed: 12.08.22).

15. U. S. Department of Health and Human Services. Budget and performance. Available at: https://www.hhs.gov/programs/index.html (accessed: 12.08.22).

16. Kostyaev S.S. Reforma zdravookhraneniya v SShA [Health care reform in the United States], Ekonomicheskie i sotsial'nye problemy Rossii [Russia's economic and social problems], 2011, no. 2, pp. 32—45.

17. Shvedova N.A. Zdravookhranenie v SShA i COVID-19: bor'ba prodolzhaetsya [Health care in the U.S. and COVID19: the struggle continues], SShA & Kanada: Ekonomika — politika — kul'tura [USA & Canada: economy - politics - culture], 2021, Issue 12, pp. 5—17. DOI: 10.31857/S268667300017537-0.