Scott L Greer

University of Michigan | U-M · Department of Health Management & Policy

Why has it been so difficult to reform U.S. policing? We provide a theoretical argument that understanding of the entrenched militarisation and accountability problems of U.S. police departments would benefit from using theory in comparative research on civil–military relations. American police forces undermine local democracy by encroaching upon t...

Factors outside of healthcare services determine our health and this involves many different sectors. Health for All Policies changes the argument about inter-sectoral action, from one focusing on health and the health sector to one based on co-benefits – a 'Health for All Policies' approach. It uses the Sustainable Development Goals as the framewo...

How did partisanship impact rhetoric about, public opinion of, and policies that prioritize racial and ethnic health disparities of COVID-19, during the first wave of the pandemic between March and July 2020? In this retrospective, mixed-methods analysis using national administrative and survey data, we found that the rhetoric and policy of shared...

Equitable allocation and distribution of the COVID-19 vaccine has proven to be a major policy challenge exacerbated by incomplete pandemic risk data. To rectify this shortcoming, a three-step data visualization methodology was developed to assess COVID-19 vaccination equity in the United States using state health department, US Census, and CDC data...

Oppression and inequality, as critical social and structural determinants of health, are key threats to public health. Democratic stability provides institutional measures to mitigate oppression and inequality. We investigate trends in democratic backsliding in the Organization for Economic Co‐operation and Development (OECD) nations, overall, and...

In March 2020, the COVID-19 pandemic shook the European Union (EU). The EU responded to the multifaceted challenge with an integrative leap forward. Member States substantially increased their investment in existing health policy tools such as civil protection and financing for health initiatives. There was innovation in EU law, where a process of...

The COVID-19 pandemic of 2020 was one of the rare events that shocked almost every world government simultaneously, thus creating an unusual opportunity to understand how political institutions shape policy decisions. There have been many analyses of what governments did. We focus instead on what they could do, focusing on the institutional politic...

Rural areas face well known and distinctive health care challenges that can limit their resilience in the face of health emergencies such as the COVID-19 pandemic. These include problems of sparsity and consequent limited health care provisioning; poverty, inequalities, and distinctive economic structures that limit access to health care; and under...

Worldwide responses to the COVID-19 pandemic have shown that it is possible for politicians to come together across departmental boundaries. To this end, in many countries, heads of government and their health ministers work closely with all other ministries, departments, and sectors, including social affairs, internal affairs, foreign affairs, res...

The UK's relationship with the European Union (EU) is now embodied in two principal legal instruments: the EU–UK Trade and Cooperation Agreement, which formally entered into force on 1 May 2021; and the Withdrawal Agreement, with its Protocol on Ireland/Northern Ireland, which continues to apply. Using a ‘building blocks’ framework for analysis of...

Strategic purchasing is a popular and frequently proposed policy for improving the efficiency and adaptiveness of health systems. The COVID-19 pandemic shocked health systems, creating a test of the adaptability and resiliency of their key features. This research study explores (i) what role purchasing systems and agents played in the COVID-19 pand...

Strategic purchasing is a popular and frequently proposed policy for improving the efficiency and adaptiveness of health systems. The COVID-19 pandemic shocked health systems, creating a test of the adaptability and resiliency of their key features. This research study explores (i) what role purchasing systems and agents played in the COVID-19 pand...

This chapter explores the implications of the COVID-19 pandemic for the EU’s health policy. Health is an area where member states have historically been reluctant to cede powers. Consequently, the EU’s treaty competences in health are limited. The chapter introduces the extent and parameters of the EU’s role and the resulting patchwork of health po...

COVID-19 led to significant and dynamic shifts in power relations within and between governments, teaching us how governments make health policies and how health crises affect government. We focus on centralization and decentralization within and between governments: within government, meaning the extent to which the head of government controls pol...

In this chapter, we analyze the health and social policies that emerged in the first six months of the pandemic, to combat COVID-19 in the US. These policies have a complicated record. The US has largely failed in their efforts to combat COVID-19 through public health policies. In the weeks after the pandemic declaration, the US appropriated trilli...

Background Given that there is not much evidence that ageing imperils the finance and provision of health care, why do so many policymakers act like it does? Methods We break conventional wisdom down into myths and realities, identifying the evidence against them. Results A first myth is that ageing produces unsustainable health care costs, which...

COVID-19 is not the first, nor the last, public health challenge the US political system has faced. Understanding drivers of governmental responses to public health emergencies is important for policy decision-making, planning, health and social outcomes, and advocacy. We use federal political disaster-aid debates to examine political factors relat...

While literature on politicians, parties, and voters of the populist radical right (PRR) is enormous, there is remarkably little on their policy impact and almost none on their health impact. Political science literature generally prefers to keep a distance from complex policy questions, while public health and health policy literature frequently a...

Context: Regional international organizations, from the South African Development Community (SADC) to the European Union (EU), are organizations that promote cooperation among countries in a specific region of the world. Asking what RIOs do to health and health policy by looking only at their formal health policies can understate their effects (e....

Must ageing populations create conflict between generations and crisis for health systems? Our answer is no. The problem is not so much demographic change as the political and policy challenge of creating fair, sustainable and effective policies for people of all ages. This book, based on a large European Observatory study, uses new evidence to cha...

Many efforts to predict the impact of COVID-19 on hospitalization, intensive care unit (ICU) utilization, and mortality rely on age and comorbidities. These predictions are foundational to learning, policymaking, and planning for the pandemic, and therefore understanding the relationship between age, comorbidities, and health outcomes is critical t...

Despite the alleged bias towards older people in many political institutions in Europe, this chapter argues that policymakers often do not introduce the most effective policies for supporting healthy ageing. The following pages show that while public spending on older people (e.g. pensions, old age care) remains more extensive and insulated from cu...

One of the most important political and economic challenges facing Europe and elsewhere is the ageing of societies. Must ageing populations create conflict between generations and crisis for health systems? Our answer is no. The problem is not so much demographic change as the political and policy challenge of creating fair, sustainable and effecti...

Life in an ageing society is a truly novel experience. For most of our species’ history, a large majority of people were young and life much beyond 60 seemingly a rarity (Thane, 2005). Now, populations around the world are ageing. It might be happening in countries at different speeds and to varying extents, but it is an almost universal phenomenon...

Older people are not a homogeneous social group. Their needs and abilities, and the costs associated with providing for their well-being, vary with their socioeconomic status, gender, geographic location and health status, among other relevant dimensions of difference. It should come as no surprise, then, that older adults are not a politically hom...

This book has, we hope, destroyed two straw men that are common in debates about intergenerational equity, spending and health. The first is the myth of ‘greedy geezers’ – the stereotype of a pampered pensioner, living off lavish old-age provision including fine health care, while voting against investments in future generations. The second is the...

The preceding chapters raise three issues that are crucial to understanding the politics of healthy ageing. First, older voters are not as powerful nor as unified as many politicians, think tanks and commentators often believe. While some elderly voters have preferences for policies that are in their own interests or in the interests of their child...

One of the most important political and economic challenges facing Europe and elsewhere is the ageing of societies. Must ageing populations create conflict between generations and crisis for health systems? Our answer is no. The problem is not so much demographic change as the political and policy challenge of creating fair, sustainable and effecti...

One major implication of the previous two chapters is that the politics of ageing is actually the politics of inequality – not a chimera of intergenerational inequality, but rather the inequalities that scholars of politics, social policy and health have long studied and understood (Lynch, 2020). As chapter two showed, one of the problematic assump...

Vaccines against SARS‐CoV‐2 continue to be developed at an astonishingly quick speed and the early ones, like Pfizer and Moderna, have been shown to be more effective than many public health scientists had dared to hope. As COVID‐19 vaccine research continues to progress, the world's eyes are turning toward medicine regulators. COVID‐19 vaccines ne...

It is easy but mistaken to think that public health emergency measures and social policy can be separated. This paper compares the experiences of Brazil, Germany, India and the United States during their 2020 responses to the COVID-19 pandemic to show that social policies such as unemployment insurance, flat payments and short-time work are crucial...

COVID-19 is the most significant global crisis of any of our lifetimes. The numbers have been stupefying, whether of infection and mortality, the scale of public health measures, or the economic consequences of shutdown. Coronavirus Politics identifies key threads in the global comparative discussion that continue to shed light on COVID-19 and shap...

This contributed volume is the first in-depth analysis of the health policies of populist radical right (PRR) parties worldwide and their actual involvement in health care. The prominence of authoritarian, nationalistic, and populist parties is expanding steadily. However, it is often difficult to discern what kind of policies they really stand for...

Although most governments were heavily scrutinized and looked bad early in the COVID-19 pandemic, the EU was most noticeable for its absence. This might seem strange, for an institution whose public health role has been forged through crisis—from the thalidomide tragedy and the scandal of HIV-infected blood supplies, to “mad cow disease” and the un...

Politics, rather than disease characteristics, complicated the United States response to Ebola virus disease and Zika virus. We analyze how media and political elites shaped public opinion of the two outbreaks. We conducted a retrospective analysis of media coverage, Congressional floor speech, and public opinion polls to explain elite cueing and p...

Chile has been viewed as an exemplar of social and economic progress in Latin America, with its health system attracting considerable attention. Eruption of widespread civil disorder marred this image in 2019. We trace the evolution of Chilean health policy and place it in context with developments in other sectors, pensions and education. We argue...

Public health is notoriously difficult to define, and that is the case for public health in the European Union as much as other political systems. In this article, the authors try to identify the actual scope and meaning of public health as it is institutionalized in the EU political system. Using a mixture of historical policy and legal analysis,...

European Union (EU) fiscal governance, especially the European Semester, is an ambitious new governance architecture involving surveillance and discipline, across both Eurozone and non-Eurozone member state policies, in pursuit of fiscal rigor. It is the most recent of several attempts to expand EU powers over member state policy with the goal of a...

The professional autonomy of physicians often requires they take responsibility for life and death decisions, but they must also find ways to avoid bearing the full weight of such decisions. We conducted in‐person, semi‐structured interviews with neonatologists (n = 20) in four waves between 1978 and 2017 in a single Midwestern U.S. city. Using ope...

Policy Points • Strategically purchasing health care has been and continues to be a popular policy idea around the world. • Key asymmetries in information, market power, political power, and financial power hinder the effective implementation of strategic purchasing. • Strategic purchasing has consistently failed to live up to its promises for the...

This commentary considers the impact of the coronavirus disease 2019 (COVID-19) pandemic on the study of populist radical right (PRR) politicians and their influence on public health and health policy. A systematic review of recent research on the influence of PRR politicians on the health and welfare policies shows that health is not a policy aren...

Objectives This study sought to understand the different approaches taken to involving the public in service reconfiguration in the four United Kingdom health systems. Methods This was a multi-method study involving policy document analysis and qualitative semi-structured interviews in England, Northern Ireland, Scotland and Wales. Results Despit...

COVID-19 has created a ramifying public health, economic, and political crisis throughout many countries in the world. While globally the pandemic is at different stages and far from under control in some countries, now is the time for public health researchers and political scientists to start understanding how and why governments responded the wa...

After implementing restrictions to curb the spread of coronavirus, governments in the United States and around the world are trying to identify the path to social and economic recovery. The White House and the Centers for Disease Control and Prevention have published guidelines to assist US states, counties, and territories in planning these effort...

While policy attention is understandably diverted to COVID-19, the end of the UK's post-Brexit 'transition period' remains 31 December 2020. All forms of future EU-UK relationship are worse for health than EU membership, but analysis of the negotiating texts shows some forms are better than others. The likely outcomes involve major negative effects...

Transforming health care: the policy and politics of service reconfiguration in the UK's four health systems – CORRIGENDUM - Ellen Stewart, Scott L. Greer, Angelo Ercia, Peter D. Donnelly

The boldest US states are reopening in the same ways as European countries, but with less public health and social policy support. Full text at The Conversation: https://theconversation.com/what-us-states-can-learn-from-covid-19-transition-planning-in-europe-137694

Bringing together the results of a large-scale review of European Union (EU) policies affecting health and a large-scale analysis of social policy and federalism, this paper uses comparative federalism to identify the scope and tensions of EU health policy at the end of the Juncker Commission. Viewing health care and public health policy through th...

International comparisons of US health care are common but mostly focus on comparing its performance to peers or asking why the United States remains so far from universal coverage. Here the authors ask how other comparative research could shed light on the unusual politics and structure of US health care and how the US experience could bring more...

Arms' length bodies are often seen as a tool of technocratic governance, designed to insulate decision-making from the politicizing pressures of populist influence. This article examines a subset of arms' length bodies in the UK which challenge this convention: agencies which exist to 'champion' the voice of patients and the public in the four NHS...

Brexit has direct and indirect negative health consequences, whether from economic damage or from the political paralysis and distraction from public health that it has created. Brexit is a public health problem in its own right, as other literature has shown-but, we argue, it is also a symptom of deeper problems in the governance of the United Kin...

Background Why, fundamentally, are the politics and public opinion of ageing and health so badly mis-aligned with facts about the costs of ageing societies? The literature has for decades characteristically divided between an old politics of expansion and the post-1990s new politics of recalibration and austerity. The problem for understanding the...

A round table comprising three panelists will discuss the topic from different perspectives. • Gabrielle Jacob, WHO: The WHO Global Code of Practice on the International Recruitment of Health Personnel. How far have we come, where are we now and what’s next? • Natasha Azzopardi-Muscat, EUPHA President: The role of public health in raising awarenes...

Background Public health in the UK exists on a continuum from a national and medical pole to a local and social pole, with each end threatening obliteration as a distinctive field of expertise and action. The national-medical produces a subfield of medicine, with a range of highly developed skills including epidemiology. The local-social, manifeste...

Background Do political parties matter to health? Do they affect population health either directly, or through welfare states’ social policies and the eligibility, affordability and quality of health systems? And if they do, how? These are crucial questions if we are to understand health politics or shape public health policy, particularly given th...

Background Data and knowledge on the migrant health workforce are poorly developed, and we do not understand which institutional contexts may foster responsible governance. This introduction seeks to set the scene for critical debate by placing the structure and composition of the migrant health workforce in the context of health systems and policy...

US political debates often refer to the experience of “single-payer” systems such as those of Canada and the United Kingdom. We argue that single payer is not a very useful category in comparative health policy analysis but that the experiences of countries such as Canada, the United Kingdom, Spain, Sweden, and Australia provide useful lessons. In...

Where hybrid threats represent potential disruptions to interlaced and interdependent systems within national and local governments, companies, and even individual households, methodologies are needed to help identify and understand 1) the source of the disruptions; 2) the system vulnerabilities they exploit with varying degrees of success; and 3)...

Regulation of rapidly developing changing policy areas is a well-known challenge for any government. It can involve balancing factors from elite factional politics to development strategies, national security, and public health. In the regulation of science and technology, regulation is made harder by limited data for risk assessment and policymaki...

Background: Do political parties matter to health? Do they affect population health either directly or through welfare states' social policies and the eligibility, affordability and quality of health systems? And if they do, how? These are crucial questions if we are to understand health politics or shape public health policy, particularly given t...

Carolyn Hughes Tuohy (2018), Remaking Policy: Scale, Pace, and Political Strategy in Health Care Reform, Toronto: University of Toronto Press, $55.00, pp. 688, pbk. - Volume 48 Issue 4 - SCOTT L. GREER

Public involvement in service change has been identified as a key facilitator of health care transformation (Foley et al ., 2017) but little is known about how health policy influences whether and how organisations involve the public in change processes. This qualitative study compares policy and practice for involving the public in major service c...

All forms of Brexit are bad for health, but some are worse than others. This paper builds on our 2017 analysis using the WHO health system building blocks framework to assess the likely effects of Brexit on the National Health Service (NHS) in the UK. We consider four possible scenarios as follows: a No-Deal Brexit under which the UK leaves the EU...

If disaster responses vary in their effectiveness across communities, health equity is affected. This paper aims to evaluate and describe variation in the federal disaster responses to 2017 Hurricanes Harvey, Irma and Maria, compared with the need and severity of storm damage through a retrospective analysis. Our analysis spans from landfall to 6 m...

Many authoritative documents on improving health equity name policy coherence as a necessary part of policy to address health inequities.1 While not all of them explain the logic, the reason is to be found in the failure of single policies to address intersecting inequities affecting health. Examples are not hard to imagine, or to find in the liter...

This paper presents the basic political science consensus on parties and their impact on policy, then turns to focus on the impact of the populist radical right (PRR) parties on policy, what PRR parties have done to implement their views and whether they make a difference. Three effects on policy were established: 1) they de-emphasize the issue, pr...

Public health is about policy, power, and the public and as such might be thought necessarily political. That does not mean, however, that the place of political analysis and engagement in public health is uncontroversial, and there have been longstanding arguments that to discuss politics sullies the scientific nature of public health. This articl...

The Politics of Bad Policy in the United States - Volume 16 Issue 2 - Scott L. Greer

Governance, how decisions are made and implemented, is an important part of health care and health policy. It is also the subject of a large and often confusing literature. This chapter presents the results of a review of the governance literature for health. First, it notes that not all problems are of governance. Second, it introduces five domain...

The territorial politics of health is both underexploited by mainstream political scientists and the subject of a large and distinctive health policy literature that rarely connects with political science. This chapter first argues for the usefulness of health as a source of data for a more grounded and policy-­‐focused territorial politics. It the...

Strategic purchasing of health care services is widely recommended as a policy instrument. We conducted a review of literature of material drawn from the European Observatory on Health Systems and Policies Health Systems in Transition series, other European Observatory databases, and selected country-specific literature to augment the comparative a...

Public health is about policy, power, and the public and as such might be thought necessarily political. That does not mean, however, that the place of political analysis and engagement in public health is uncontroversial, and there have been longstanding arguments that to discuss politics sullies the scientific nature of public health. This articl...

If public health is the field that diagnoses and strives to cure social ills, then understanding political causes and cures for health problems should be an intrinsic part of the field. In this article, we argue that there is no support for the simple and common, implicit model of politics in which scientific evidence plus political will produces h...