Daniel M. Fox gives an incisive assessment of the critical collaboration between researchers and public officials that has recently emerged to evaluate the effectiveness and comparative effectiveness of health services. Drawing on research as well as his first-hand experience in policymaking, Fox's broad-ranging analysis describes how politics, public finance and management, and advances in research methods made this convergence of science and governance possible. The book then widens into a sweeping history of central issues in research on health services and health governance during the past century. Returning to the past decade, Fox looks closely at how policy informed by research has been made and implemented in public programs that cover pharmaceutical drugs in most American states. This case study illuminates how politics has informed the questions, methods, and reception of research on health services, and also sheds new light on how research has informed politics and public management. Looking toward the future, Fox describes the promise, as well as the fragility, of the convergence of science and governance, making his book essential reading for those struggling to revise health care in the United States over the next several years.
Preface: Converging Stories
1. Why Convergence? Why Now?
2. Research on Health Services and the Politics of Health
3. The Competence of States in Health Policy
4. The Drug Effectiveness Review Project
5. Can Convergence be Sustained?
Daniel M. Fox is President Emeritus of the Milbank Memorial Fund. His previous books include Power and Illness: The Failure and Future of American Health Policy; Health Policy, Health Politics: The British and American Experience (1911-1965); and The Discovery of Abundance: Simon Patten and the Transformation of Social Theory, which won the Beveridge Prize of the American Historical Association.
"Throughout his distinguished career in public policy, academia, and philanthropy, Daniel Fox has epitomized the concept of convergence. In his new book, The Convergence of Science and Governance, he provides a living, engrossing case study of visionary policymakers who connected with savvy researchers to change the face of pharmaceutical policy and practice in the United States. In the process, he provides compelling histories of health services research and state health policy over the past 100 years. His smart and pragmatic optimism always shine through."—John E. McDonough, author of Experiencing Politics
"Built on a scaffolding of personal experience and historical analysis, Fox's important study provides us with an understanding of how policy analysis has emerged as a powerful force in shaping our health system. This is a refreshing book that is written to alert us to both the value of health services research and the forces that threaten its integrity."—David Rosner, author of Are We Ready? Public Health Since 9/11
"Dan Fox's razor sharp observational and analytical skills are on full display in his latest book. His story—compellingly told—chronicles how state leaders have fulfilled their charge to be "laboratories of change" by showing how to use research to inform public policy decision. It is an example federal policy makers should emulate as they attempt to reform our badly broken health care system."—John A. Kitzhaber, M.D. and Governor of Oregon 1995-2003