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Social Movements and the Transformation of American Health Care$
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Jane Banaszak-Holl, Sandra Levitsky, and Mayer Zald

Print publication date: 2010

Print ISBN-13: 9780195388299

Published to Oxford Scholarship Online: September 2010

DOI: 10.1093/acprof:oso/9780195388299.001.0001

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Mobilizing for Reform *

Mobilizing for Reform *

Cohesion in State Health Care Coalitions

Chapter:
(p.64) 5 Mobilizing for Reform*
Source:
Social Movements and the Transformation of American Health Care
Author(s):

Holly Jarman

Scott L. Greer

Publisher:
Oxford University Press
DOI:10.1093/acprof:oso/9780195388299.003.0005

Jarman and Greer consider how the fragmentation of the U.S. political system acts as a key obstacle to state‐wide universal health insurance coverage. The “paradox of purity” poses a difficult dilemma for reformers: groups with influence among policymakers have a better of chance of seeing their reforms enacted, but to be successful, they must adopt narrower policy goals or accept smaller reforms. Less influential groups are free to “think big,” but have a greatly reduced chance of seeing their goals implemented. Jarman and Greer consider how a social movement for health reform might resolve this paradox. Their chapter analyzes the campaigns for universal health coverage in Pennsylvania and Wisconsin, contrasting the fragmentation of Pennsylvania activists with the coalition‐building techniques developed in Wisconsin to assess how proponents of big ideas can successfully build a support base broad enough to overcome a fragmented U.S. political system.

Keywords:   social movements, collective action, health care, policy reform, mobilization, interest groups, health insurance, coalitions

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