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Social Solidarity in Health Care, American-Style
Erin C Fuse Brown1, Matthew B Lawrence1, Elizabeth Y McCuskey1
1Erin C. Fuse Brown, J.D., M.P.H., is an Associate Professor of Law and Director of the Center for Law, Health & Society at Georgia State University College of Law. Elizabeth Y. McCuskey, J.D., is a Professor of Law, University of Massachusetts School of Law. Matthew B. Lawrence, J.D., is an Associate Professor of Law, Emory University School of Law. Lindsay F. Wiley, J.D., M.P.H., Professor of Law and Director of the Health Law and Policy Program at American University Washington College of Law.
The Affordable Care Act aimed for social solidarity in US health policy but faces barriers. Four legal structures—federalism, fiscal pluralism, privatization, and individualism—must be addressed for true health care solidarity.
Area of Science:
- Health Policy Analysis
- Socioeconomic Determinants of Health
Background:
- The Affordable Care Act (ACA) aimed to reform U.S. health policy.
- The reform shifted focus from actuarial fairness towards social solidarity.
- Existing legal structures may impede the ACA's goals.
Purpose of the Study:
- To identify the legal barriers preventing social solidarity in U.S. health care.
- To analyze how specific legal fixtures hinder the ACA's objectives.
- To propose future reform directions.
Main Methods:
- Qualitative analysis of U.S. health policy.
- Examination of legal frameworks within the healthcare system.
- Review of principles guiding health policy reform.
Main Results:
- Four key legal fixtures impede social solidarity: federalism, fiscal pluralism, privatization, and individualism.
- These structures create persistent challenges to achieving equitable health care.
- The ACA's success in fostering solidarity is limited by these entrenched systems.
Conclusions:
- Achieving social solidarity in American health care requires confronting fundamental legal structures.
- Future health policy reforms must address federalism, fiscal pluralism, privatization, and individualism.
- Overcoming these barriers is essential for realizing a more equitable health system.
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