The role of corporatism in health policy-making at the state level.

Abstract

Through a cross-sectional study of 120 organized interests active during the Eighty-Third Legislature in the state of Michigan this dissertation addresses the lack of congruence between the traditional pluralist theory and the reality of interest group political behavior in the American health policy domain. Emphasis is placed on the development and application of a more complete theory of group politics through the use of two paradigms, corporatism and pluralism, that are conceptually different, but logically related along a consistent set of dimensions. Correlation, factor and regression analyses, and four case studies were used to evaluate the role of corporatism in health policy making at the state level. The study findings show that corporatist groups are a factor to be contended with in the health policy domain because of the extent of their activity but not because of any dictatorial ability to determine the content and intent of health policy. The most effective groups in the Michigan health policy domain were those organized interests having traits ascribed to both prototypical corporatist and pluralist groups. The inability of corporatist groups to consistently shape health legislation does not minimize the utility of a more complete theory of group politics for health policy analysis. Because corporatism and pluralism were used to assess the political effectiveness of organized interests, a method for identifying effective groups by their trait clusters and for predicting which groups will have a comparative advantage in a policy arena is now available. Future research using a more complete theory of group politics should focus on investigating more than one arena of legislative activity using longitudinal data.