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Do targeted efforts for the rural underserved help kill comprehensive reform?

D H Taylor1

  • 1Center for Health Policy, Law and Management, Terry Sanford Institute of Public Policy, Duke University, Durham, NC 27708, USA.

The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association
|August 7, 1999
PubMed
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The focus on underserved rural areas, formalized by the war on poverty, has sustained programs like Community Health Centers. This targeted approach may hinder comprehensive health reform efforts.

Area of Science:

  • Health Services Research
  • Public Health Policy
  • Rural Health

Background:

  • Historically, the entire nation was considered underserved.
  • A shift occurred 60 years ago towards identifying specific underserved areas, particularly rural regions.
  • This focused approach was formalized during the war on poverty.

Purpose of the Study:

  • To analyze the evolution of defining and addressing underserved areas in the U.S.
  • To examine the impact of focused programmatic responses on health policy.
  • To assess the role of these targeted efforts in broader health reform debates.

Main Methods:

  • Historical analysis of health policy and program development.
  • Review of federal health center program evolution and funding.

Related Experiment Videos

  • Examination of the concept of 'exception' phenomenon in policy discourse.

    • Main Results:

    • The notion of underserved areas shifted from national to geographically focused, especially rural.
    • Federal health center programs, like Community Health Centers, have shown political resilience.
    • The 'exception' framing enhances the survival of targeted programs but may impede comprehensive reform.

    Conclusions:

    • The consensus viewing rural underserved areas as an 'exception' strengthens targeted programs.
    • This framing may contribute to the defeat of comprehensive health reform by focusing on special responses.
    • Policy networks advocating for remedial efforts can influence reform outcomes.