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Universal health care was on the national political agenda for nearly a hundred years until a comprehensive (but not universal) health care reform bill supported by President Obama passed in 2010. The most common explanation for the failure of past reform efforts is that special interests were continually able to block reform by lobbying lawmakers. Yet, beginning in the 1970s, accelerating with the failure of the Clinton health care plan, and continuing through the passage of the Affordable Care Act in 2010, health policy reform was alive and well at the state level. Interest Groups and Health Care Reform across the United States assesses the impact of interest groups to determine if collectively they are capable of shaping policy in their own interests or whether they influence policy only at the margins. What can this tell us about the true power of interest groups in this policy arena? The fact that state governments took action in health policy in spite of opposing interests, where the national government could not, offers a compelling puzzle that will be of special interest to scholars and students of public policy, health policy, and state politics.
Updated to include a new chapter about the influence of social media and the Internet—the 20th anniversary edition of Bowling Alone remains a seminal work of social analysis, and its examination of what happened to our sense of community remains more relevant than ever in today’s fractured America. Twenty years, ago, Robert D. Putnam made a seemingly simple observation: once we bowled in leagues, usually after work; but no longer. This seemingly small phenomenon symbolized a significant social change that became the basis of the acclaimed bestseller, Bowling Alone, which The Washington Post called “a very important book” and Putnam, “the de Tocqueville of our generation.” Bowling Alone surveyed in detail Americans’ changing behavior over the decades, showing how we had become increasingly disconnected from family, friends, neighbors, and social structures, whether it’s with the PTA, church, clubs, political parties, or bowling leagues. In the revised edition of his classic work, Putnam shows how our shrinking access to the “social capital” that is the reward of communal activity and community sharing still poses a serious threat to our civic and personal health, and how these consequences have a new resonance for our divided country today. He includes critical new material on the pervasive influence of social media and the internet, which has introduced previously unthinkable opportunities for social connection—as well as unprecedented levels of alienation and isolation. At the time of its publication, Putnam’s then-groundbreaking work showed how social bonds are the most powerful predictor of life satisfaction, and how the loss of social capital is felt in critical ways, acting as a strong predictor of crime rates and other measures of neighborhood quality of life, and affecting our health in other ways. While the ways in which we connect, or become disconnected, have changed over the decades, his central argument remains as powerful and urgent as ever: mending our frayed social capital is key to preserving the very fabric of our society.