The balance between state and federal health care financing for low-income people has been a matter of considerable debate for the last 40 years. Some argue for a greater federal role, others for more devolution of responsibility to the states. Medicaid, the backbone of the system, has been plagued by an array of problems that have made it unpopular and difficult to use to extend health care coverage. In recent years, waivers have given the states the flexibility to change many features of their Medicaid programs; moreover, the states have considerable flexibility to in establishing State Children's Health Insurance Programs. This book examines the record on the changing health safety net. How well have states done in providing acute and long-term care services to low-income populations? How have they responded to financial incentives and federal regulatory requirements? How innovative have they been? Contributing authors include Donald J. Boyd, Randall R. Bovbjerg, Teresa A. Coughlin, Ian Hill, Michael Housman, Robert E. Hurley, Marilyn Moon, Mary Beth Pohl, Jane Tilly, and Stephen Zuckerman.

Ghana's government has embarked on a decentralization process since the 1980s, but the intended devolution of the health system faces important challenges and shortfalls. This study analyzes the strengths and weaknesses of the decentralization of the Ghanaian health system.

This book explores the effects of devolution on the policy process, policy substance and policy outcomes in the United Kingdom, Spain and Belgium. It examines the scope for policy innovation within devolved governments, and considers the political and policy interdependence that remains between governments at each level of the state.

In recent years the pace of reform in health policy and the NHS has been relentless. But how are policies formed and implemented? This fully updated edition of a bestselling book explores the processes and institutions that make health policy, examining what constitutes health policy, where power lies, and what changes could be made to improve the quality of health policy making. Drawing on original research by the author over many years, and a wide range of secondary sources, the book examines the role of various institutions in the formation and implementation of health policy. Unlike most standard texts, it considers the impact of devolution in the UK and the role of European and international institutions and fills a need for an up-to-date overview of this fast-moving area. It features new case studies to illustrate how policy has evolved and developed in recent years. This new edition has been fully updated to reflect policies under the later years of New Labour and the Coalition government. Although written particularly with the needs of students and tutors in mind, this accessible textbook will also appeal to policy makers and practitioners in the health policy field.