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The Divided State of American Healthcare

Red States Sing the Blues

Kant Patel Mark E Rushefsky (Missouri State University, USA)

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English
Routledge
16 April 2025
Political polarization among ‘red’ and ‘blue’ states in the United States is reflected in major divides that exist along social, economic, educational, geographic, and demographic lines, but nowhere is polarization and political divide more evident than in the field of American healthcare. This book examines the healthcare divide between the red and blue states.

In this book, authors Kant Patel and Mark Rushefsky analyze how political polarization at the state level has impacted state health policymaking, policy outputs, and policy outcomes and led red and blue states to create vastly different healthcare and health policies. And, as state governments enjoy a considerable amount of authority and discretionary power, the authors further examine how polarization has influenced the implementation of national health policies by the red and blue states. The book begins with an exploration of the origins and evolution of political polarization and the factors that have contributed to it at the national level. This is followed by an analysis of how political polarization separates red and blue states and how they differ from each other in political, economic, demographic, and racial dimensions. It then considers how the health profiles of red and blue states differ in health indicators such as the uninsured or underinsured population, healthcare spending, and healthcare access. The book analyzes how political polarization has produced vastly different sets of health policies on issues including the Affordable Care Act (ACA), Medicaid, reproductive rights, and the COVID-19 pandemic. The book concludes with a critical examination of proposed solutions to political polarization and the dangers of our current deeply divided political climate.

Written in an accessible and jargon-free style, The Divided State of American Healthcare is vital reading for undergraduate and graduate courses on health policy, public policy, political science, and public health. It will also be of keen interest to healthcare professionals in the public and private sectors.
By:   , ,
Imprint:   Routledge
Country of Publication:   United Kingdom
Dimensions:   Height: 229mm,  Width: 152mm, 
ISBN:   9781032671116
ISBN 10:   1032671114
Pages:   428
Publication Date:  
Audience:   College/higher education ,  Primary
Format:   Paperback
Publisher's Status:   Forthcoming

Kant Patel is Emeritus Professor of Political Science at Missouri State University, USA. Mark E. Rushefsky is Emeritus Professor of Political Science at Missouri State University, USA.

Reviews for The Divided State of American Healthcare: Red States Sing the Blues

“Patel and Rushefsky for some time have been among the more thoughtful observers of healthcare policy in America. The Divided State of American Healthcare continues their excellent work. It provides a comprehensive examination of some of the major themes in American thought that affect healthcare policy. They make it clear that religious and political beliefs, for example, often substitute for scientific findings in the minds of far too many citizens, especially in “red states.” Those states suffer accordingly. Ever since Shakespeare assured us that “the truth will out,” advocates of self-government and education have been optimistic. Today, though, the efforts of one of America’s two major political parties have become fervently re-oriented toward ensuring that the truth will not “out;” rather it will be stamped out—even with regard to healthcare. Patel and Rushefsky here—albeit tactfully—take their place among those seeking to preserve the search for truth, not suppress it.” Max J. Skidmore, University of Missouri Curators’ Distinguished Professor Emeritus, USA “Although there are studies which explore how polarized politics in America have impacted the social, and moral policies of state governments, the question that scholars have pondered for many years is whether or not the health care of the American people has also been conditioned by the polarized and tribal character of contemporary American politics. That question has finally been answered by Kant Patel and Mark Rushefsky in The Divided State of American Healthcare: Red States Sing the Blues. A cutting edge and empirically based volume consisting of nine clearly written chapters, the authors demonstrate with impressive bodies of evidence that a state’s politics and political values have direct bearing on the health care of those who reside within its borders. A very helpful volume for courses related to public policy, state and local government, or political parties.” Gary L. Rose, Professor of Politics, Scholar in Residence, Sacred Heart University, USA “Few issues have had a longer political road to travel than health care. This is particularly true with the nation's increased polarization and ""red"" state politics. Now, Patel and Rushefsky return to the topic for which they're nationally recognized to assess how residents in GOP-controlled states have lost out in the decade since the Affordable Care Act. Accessible and engaging, their book is a must-read for anyone interested in health care, federalism, and public management.” Brian Calfano, Professor of Journalism, University of Cincinnati, USA “When it comes to health care, do different people living in different states have different odds of getting good care and living longer? In this new book, Patel and Rushefsky dig into the data to demonstrate the distinctive results that flow from America’s political system. It’s a central part of the culture wars that have broken out between the states, and their analysis helps the reader understand where this comes from—and why it matters to twenty-first century governance.” Donald F. Kettl, Professor Emeritus and Former Dean, School of Public Policy, University of Maryland, USA “Long well-known in the field of Health Care policy, Professors Kant Patel and Mark Rushefsky’s newest book provides a comprehensive understanding to key U.S. health policy issues surrounding the Democratic (Blue State) and Republican (Red State) responses to current health care issues. Each main chapter investigates differing party responses, including policy preferences, to contemporary health care challenges, such as Medicaid, Reproductive Rights, Right to Die and Physician-Assisted Suicide, and the COVID-19 Pandemic. This book stands out as the definitive history of how Democrats and Republicans approach the American health care system. While each offers a unique mix of public and private programs, Rushefsky and Patel painstakingly retrace the various policy preferences of key health care issues. They offer a play-by-play breakdown of each party’s approach and the differences between the two, which, in turn, will ultimately shaped America’s health care policy.” Ken Rutherford, Professor, Political Science, James Madison University; Co-Founder of the Landmine Survivors Network, co-recipient of the 1997 Nobel Peace Prize as part of the global international campaign to ban landmines.


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