Lawrence Brown - Academia.edu (original) (raw)

Papers by Lawrence Brown

Research paper thumbnail of Active Living as an Institutional Challenge: Lessons from the Robert Wood Johnson Foundation's “Celebrate Fitness” Program

Journal of Health Politics, Policy and Law, 2008

Native American youth suffer disproportionately from a range of adverse health conditions. Empowe... more Native American youth suffer disproportionately from a range of adverse health conditions. Empowering youth leaders to work on community-based solutions has proved effective in reducing tobacco use and gun violence and is now emerging as a promising approach to improving fitness and health. This article, based on direct observation and interviews with key informants, examines the implementation of a Robert Wood Johnson Foundation–funded project that gave tribal youth councils minigrants to design and run diverse projects that encourage physical activity in their communities. The article highlights the institutional challenges that confront health-promotion strategies for disadvantaged populations. Unless they take proper account of organizational, political, environmental, and cultural forces, funders' interventions have limited chances for success and sustainability.

Research paper thumbnail of Poor Program's Progress: The Unanticipated Politics Of Medicaid Policy

Health Affairs, 2003

Pondering the reasons why Medicaid is not so poor a program after all may clarify the debate abou... more Pondering the reasons why Medicaid is not so poor a program after all may clarify the debate about how to expand coverage.

Research paper thumbnail of Saltman on solidarity

Israel journal of health policy research, 2015

Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health... more Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health care systems is being reconsidered in the light of today's austere economic conditions. Solidarity, he argues, has always been a flexible moral guideline, one that allows for policy responses, such as limitations on health benefits or increased out of pocket payments, that challenging fiscal conditions are said to demand. Here we consider what the basic elements in solidarity - universality, redistribution, and uniformity-- mean in health as compared to other social policy realms such as pensions. Traditionally, the commitment to solidarity said little about the contents of services, but the latter is perhaps subject to increasing scrutiny under the health policy microscope. Saltman is right to emphasize the conceptual and cross-national flexibility of solidarity, but the notion retains a solid and durable core that continues to give valuable direction to policymakers in search of a...

Research paper thumbnail of Saltman on solidarity

Israel journal of health policy research, 2015

Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health... more Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health care systems is being reconsidered in the light of today's austere economic conditions. Solidarity, he argues, has always been a flexible moral guideline, one that allows for policy responses, such as limitations on health benefits or increased out of pocket payments, that challenging fiscal conditions are said to demand. Here we consider what the basic elements in solidarity - universality, redistribution, and uniformity-- mean in health as compared to other social policy realms such as pensions. Traditionally, the commitment to solidarity said little about the contents of services, but the latter is perhaps subject to increasing scrutiny under the health policy microscope. Saltman is right to emphasize the conceptual and cross-national flexibility of solidarity, but the notion retains a solid and durable core that continues to give valuable direction to policymakers in search of a...

Research paper thumbnail of The political economy of rationing health care in England and the US: the ‘accidental logics’ of political settlements

Health Economics, Policy and Law, 2014

This article considers how the ‘accidental logics’ of political settlements for the English Natio... more This article considers how the ‘accidental logics’ of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing, which we define to be the denial of health care that is beneficial but is deemed to be too costly. This article argues that rationing is designed into the English NHS and designed out of US Medicare; and compares rationing for the elderly in the United States and in England for acute care, care at the end of life, and chronic care.

Research paper thumbnail of Charge Of The Right Brigade? Communities, Coverage, And Care For The Uninsured

Health Affairs, 2006

The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourt... more The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourteen communities that aimed to expand health insurance coverage and improve care for their uninsured residents. Our examination of seven program sites suggests that despite solid community leadership and carefully crafted plans, political, economic, and organizational obstacles precluded much expansion of coverage and constrained reforms. Redistribution of financial and organizational resources among both mainstream and safety-net institutions in these communities was hard to achieve. CIC's record offers little evidence that communities are better equipped than are other sectors of U.S. society to solve the problem of uninsurance. [Health Affairs 25 (2006): w150-w161

Research paper thumbnail of Introduction: Evaluation in Analytic Theory and Political Practice

Journal of Health Politics, Policy and Law, 2013

Research paper thumbnail of Introduction: Evaluation in Analytic Theory and Political Practice

Journal of Health Politics, Policy and Law, 2013

Research paper thumbnail of Special R e po rt Promising Practices: How Leading Safety-Net Plans Are Managing The Care Of Medicaid Clients These plans rely on tools that emphasize partnership with providers, rather than the command-style tools of managed care

Health plans formed by safety-net providers serve large numbers of Medicaid beneficiaries. Throug... more Health plans formed by safety-net providers serve large numbers of Medicaid beneficiaries. Through a series of case studies, we examined the care management tools used by leading safety-net plans. These plans do not rely on the coercive, command-style tools of managed care. They rely instead on tools that emphasize partnership with provid- ers: sharing data about practice patterns, using provider

Research paper thumbnail of Active Living as an Institutional Challenge: Lessons from the Robert Wood Johnson Foundation's “Celebrate Fitness” Program

Journal of Health Politics, Policy and Law, 2008

Native American youth suffer disproportionately from a range of adverse health conditions. Empowe... more Native American youth suffer disproportionately from a range of adverse health conditions. Empowering youth leaders to work on community-based solutions has proved effective in reducing tobacco use and gun violence and is now emerging as a promising approach to improving fitness and health. This article, based on direct observation and interviews with key informants, examines the implementation of a Robert Wood Johnson Foundation–funded project that gave tribal youth councils minigrants to design and run diverse projects that encourage physical activity in their communities. The article highlights the institutional challenges that confront health-promotion strategies for disadvantaged populations. Unless they take proper account of organizational, political, environmental, and cultural forces, funders' interventions have limited chances for success and sustainability.

Research paper thumbnail of Poor Program's Progress: The Unanticipated Politics Of Medicaid Policy

Health Affairs, 2003

Pondering the reasons why Medicaid is not so poor a program after all may clarify the debate abou... more Pondering the reasons why Medicaid is not so poor a program after all may clarify the debate about how to expand coverage.

Research paper thumbnail of Saltman on solidarity

Israel journal of health policy research, 2015

Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health... more Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health care systems is being reconsidered in the light of today's austere economic conditions. Solidarity, he argues, has always been a flexible moral guideline, one that allows for policy responses, such as limitations on health benefits or increased out of pocket payments, that challenging fiscal conditions are said to demand. Here we consider what the basic elements in solidarity - universality, redistribution, and uniformity-- mean in health as compared to other social policy realms such as pensions. Traditionally, the commitment to solidarity said little about the contents of services, but the latter is perhaps subject to increasing scrutiny under the health policy microscope. Saltman is right to emphasize the conceptual and cross-national flexibility of solidarity, but the notion retains a solid and durable core that continues to give valuable direction to policymakers in search of a...

Research paper thumbnail of Saltman on solidarity

Israel journal of health policy research, 2015

Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health... more Richard Saltman suggests that solidarity, a cherished notion at the heart of West European health care systems is being reconsidered in the light of today's austere economic conditions. Solidarity, he argues, has always been a flexible moral guideline, one that allows for policy responses, such as limitations on health benefits or increased out of pocket payments, that challenging fiscal conditions are said to demand. Here we consider what the basic elements in solidarity - universality, redistribution, and uniformity-- mean in health as compared to other social policy realms such as pensions. Traditionally, the commitment to solidarity said little about the contents of services, but the latter is perhaps subject to increasing scrutiny under the health policy microscope. Saltman is right to emphasize the conceptual and cross-national flexibility of solidarity, but the notion retains a solid and durable core that continues to give valuable direction to policymakers in search of a...

Research paper thumbnail of The political economy of rationing health care in England and the US: the ‘accidental logics’ of political settlements

Health Economics, Policy and Law, 2014

This article considers how the ‘accidental logics’ of political settlements for the English Natio... more This article considers how the ‘accidental logics’ of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing, which we define to be the denial of health care that is beneficial but is deemed to be too costly. This article argues that rationing is designed into the English NHS and designed out of US Medicare; and compares rationing for the elderly in the United States and in England for acute care, care at the end of life, and chronic care.

Research paper thumbnail of Charge Of The Right Brigade? Communities, Coverage, And Care For The Uninsured

Health Affairs, 2006

The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourt... more The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourteen communities that aimed to expand health insurance coverage and improve care for their uninsured residents. Our examination of seven program sites suggests that despite solid community leadership and carefully crafted plans, political, economic, and organizational obstacles precluded much expansion of coverage and constrained reforms. Redistribution of financial and organizational resources among both mainstream and safety-net institutions in these communities was hard to achieve. CIC's record offers little evidence that communities are better equipped than are other sectors of U.S. society to solve the problem of uninsurance. [Health Affairs 25 (2006): w150-w161

Research paper thumbnail of Introduction: Evaluation in Analytic Theory and Political Practice

Journal of Health Politics, Policy and Law, 2013

Research paper thumbnail of Introduction: Evaluation in Analytic Theory and Political Practice

Journal of Health Politics, Policy and Law, 2013

Research paper thumbnail of Special R e po rt Promising Practices: How Leading Safety-Net Plans Are Managing The Care Of Medicaid Clients These plans rely on tools that emphasize partnership with providers, rather than the command-style tools of managed care

Health plans formed by safety-net providers serve large numbers of Medicaid beneficiaries. Throug... more Health plans formed by safety-net providers serve large numbers of Medicaid beneficiaries. Through a series of case studies, we examined the care management tools used by leading safety-net plans. These plans do not rely on the coercive, command-style tools of managed care. They rely instead on tools that emphasize partnership with provid- ers: sharing data about practice patterns, using provider