Health-care reform has more hurdles than politics

June 17, 2010 | Research, UToday
By Meghan Cunningham

Politics plays a huge role in health care in the United States, especially with the current reform debate and proposals seen earlier this year when conservatives wanted less government involvement and liberals wanted more government action.



But there are a number of other factors, such as the economy, technology, globalization and culture, that influence health care in this country. And Dr. Sunday Ubokudom, UT associate professor of political science and public administration, investigated all the factors for a comprehensive review of what affects the U.S. health-care system.

“This is the first time it has been looked at in a comprehensive manner,” he said. “We tried as much as possible to be objective and to look at all factors. If you look at just one element and let your bias impact it as others have done, you are just getting one aspect of the issue.”

His review, “The Ecology of Health Policymaking and Reform in the United States of America,” was published recently in World Medical & Health Policy.

Ubokudom, with the help of UT Medical Center research associate Jagdish Khubchandani, looked at the political effects but also identified a host of other issues such as the economy, with the $2.24 trillion spent for health care in 2007 accounting for 16.2 percent of the nation’s gross domestic product.

Demographics also play a large role with doctors choosing where to set up practices, which is more often in a city or suburb than in a rural area or the inner city. Similarly, hospital locations are driven more by financial considerations than the needs of the population, leading to duplications or shortages of care.

The authors also explored how legal ecology has an impact with insurance regulations and malpractice issues.

Ubokudom began his research before the recent health-care reform bill was passed and accurately predicted that economic and social factors needed to play large roles in the debate if reform were to happen. Still, what was passed is not enough to make substantial change because there wasn’t enough discussion of the other factors and the greater good, Ubokudom said.

“If the people send the signal that they want all the bickering and gridlock to stop and for politicians to look at the big picture and the national interest, then we will really get somewhere,” he said. “Only then shall we be able to move forward in a big way. But if narrow politics remain the main consideration and basis for every compromise, we will not make all the necessary reforms happen.”

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