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While substantial research examines the dynamics prompting policy adoption, few studies have assessed whether enacted policies are modified to meet distributional equity concerns. Past research suggests that important forces limit such adaptation, termed here "policy inertia." We examine whether block grant allocations to states from the Ryan White HIV/AIDS Program have evolved in response to major technological and political changes. We assess the impact of initial allocations on later funding patterns, compared to five counterfactual distributional equity standards. Initial allocations strongly predict future allocations; in comparison, the standards are weak predictors, suggesting the importance of policy inertia. Our methodology of employing multiple measures of equity as a counterfactual to policy inertia can be used to evaluate the adaptability of federalist programs in other domains.

While substantial research examines the dynamics prompting policy adoption, few studies have assessed whether enacted policies are modified to meet distributional equity concerns. Past research suggests that important forces limit such adaptation, termed here policy inertia. We examine whether block grant allocations to states from the Ryan White HIV/AIDS Program have evolved in response to major technological and political changes. We assess the impact of initial allocations on later funding patterns, compared to five counterfactual distributional equity standards. Initial allocations strongly predict future allocations; in comparison, the standards are weak predictors, suggesting the importance of policy inertia. Our methodology of employing multiple measures of equity as a counterfactual to policy inertia can be used to evaluate the adaptability of federalist programs in other domains. Adapted from the source document.

"May 2007." ; Includes bibliographical references (p. 69-71). ; Final ; Sponsored by the U.S. Army Research Institute for the Behavioral and Social Sciences ; Mode of access: Internet.

Health care delivery in the United States is an enormously complex enterprise, and its 1.6 trillion annual expenditures involve a host of competing interests. While arguably the nation offers among the most technologically advanced medical care in the world, the American system consistently under performs relative to its resources. Gaps in financing and service delivery pose major barriers to improving health, reducing disparities, achieving universal insurance coverage, enhancing quality, controlling costs, and meeting the needs of patients and families. Bringing together twenty-five

Frontmatter -- CONTENTS -- PREFACE -- ACKNOWLEDGMENTS -- Introduction -- CHAPTER 1. Morality, Politics, and Health Policy -- CHAPTER 2. Cross Pressures -- CHAPTER 3. The Employer-Based Health Insurance System -- CHAPTER 4. Entrepreneurial Challenges to Integrated Health Care -- CHAPTER 5. Fundamental Sources of Health Inequalities -- CHAPTER 6. A Public Health Approach to Firearms Policy -- CHAPTER 7. Tobacco Policy in the United States -- CHAPTER 8. Patterns and Causes of Disparities in Health -- CHAPTER 9. Addressing Racial Inequality in Health Care -- CHAPTER 10. Still Demanding Medical Excellence -- CHAPTER 11. Preventing Medical Errors -- CHAPTER 12. Improving Quality through Nursing -- CHAPTER 13. Improving Medicare for Beneficiaries with Disabilities -- CHAPTER 14. Specialization, Specialty Organizations, and the Quality of Health Care -- CHAPTER 15. Integrating People with Mental Illness into Health Insurance and Social Services -- CHAPTER 16. Accountability for Reasonable Limits to Care -- CONTRIBUTORS -- NAME INDEX -- SUBJECT INDEX