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Omnibus legislating is the controversial practice of combining disparate measures in one massive bill. Omnibus packages are "must-pass" bills because they have a nucleus that enjoys widespread support but they also contain a variety of often unrelated measures that are simply "hitching a ride". Why are omnibus bills employed? Why the increase in their use? Why do leaders attach certain bills to omnibus packages and not others? Glen Krutz addresses these and other questions in this original and insightful study of an important change in the legislative process. Many view omnibus packages as political vehicles and therefore attribute their rise to politics, but Krutz finds that, whatever their political value, omnibus packages are institutionally efficient. Omnibus legislating improves congressional capability by providing a tool for circumventing the gridlock of committee turf wars and presidential veto threats. In addition to furnishing a fascinating look at law-making, Hitching a Ride: Omnibus Legislating in the U.S. Congress provides a challenge to recent studies of congressional change that focus on political factors. Political and institutional factors together, Krutz argues, explain congressional evolution.
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What can be more vital to each of us than our health? Yet, despite unprecedented health care spending, the U.S. health system is substantially underperforming, especially with respect to what should be possible, given current knowledge. Although the United States is currently devoting 18% of its Gross Domestic Product to delivering medical care¿more than $3 trillion annually and nearly double the expenditure of other advanced industrialized countries¿the U.S. health system ranked only 37th in performance in a World Health Organization assessment of member nations. In Vital Directions for Health & Health Care: An Initiative of the National Academy of Medicine, the U.S. National Academy of Medicine (NAM, formerly the Institute of Medicine), which has long stood as the nation¿s most trusted independent source of guidance in health, health care, and biomedical science, has marshaled the wisdom of more than 150 of the nation¿s best researchers and health policy experts to assess opportunities for substantially improving the health and well-being of Americans, the quality of care delivered, and the contributions of science and technology. This publication identifies practical and affordable steps that can and must be taken across eight action and infrastructure priorities, ranging from paying for value and connecting care, to measuring what matters most and accelerating the capture of real-world evidence. Without obscuring the difficulty of the changes needed, in Vital Directions, the NAM offers an important blueprint and resource for health, policy, and leaders at all levels to achieve much better health outcomes at much lower cost.
Answers to environmental issues are not black and white. Debates around policy are often among those with fundamentally different values, and the way that problems and solutions are defined plays a central role in shaping how those values are translated into policy. The Environmental Case captures the real-world complexity of creating environmental policy, and this much-anticipated Sixth Edition contains 14 carefully constructed cases, including a new study of the Salton Sea crisis. Through her analysis, Sara Rinfret continues the work of Judith Layzer and explores the background, players, contributing factors, and outcomes of each case, and gives readers insight into some of the most interesting and controversial issues in U.S. environmental policymaking.