By Donna M. Nickitas

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1995). What Medicare’s architects had in mind. Health Affairs, 14(4), 62–73. Bodenheimer, T. (2005). High and rising health care costs. Part 2: Technologic innovation. Annals of Internal Medicine, 142, 932–937. , & Housman, M. (2003). State and federal roles in health care: Rationales for allocating responsibilities. In J. Holahan, A. Weil, & J. ), Federalism and Health Policy (vol. 3, pp. 25–51). Washington, DC: The Urban Institute Press. 56598_CH01_0001_0024:56598_Nickitas 22 3/1/10 12:06 PM Page 22 Chapter 1: To Engage or Not Engage Brady, D.

Organized interests in health politics and policy-making. Medical Care Review, 44(1), 89–118. Vladeck, B. (1999). The political economy of Medicare. Health Affairs, 18(1), 22–36. Wolf, G. , & Greenhouse, P. K. (2007). Blueprint for design: Creating models that direct change. Journal of Nursing Administration, 37, 9381–9387. 56598_CH01_0001_0024:56598_Nickitas 3/1/10 12:06 PM Page 24 56598_CH02_0025_0050:56598_Nickitas 3/1/10 11:26 AM Page 25 Chapter 2 Health Status and Access to Care Paula Lucey GOOD HEALTH IS ESSENTIAL TO HAPPINESS AND HAPPINESS IS AN ESSENTIAL TO GOOD CITIZENSHIP.

Implementation can be difficult because the abstract agreements made during the legislative process often fall apart if underlying conflicts have not been resolved. This makes the administrative leadership and organizational capacity of administrative agencies even more important. How an agency chooses to implement the program can have tremendous influence on its outcome (Jacobson & Wasserman, 1999; Morone, 1995; Pressman & Wildavsky, 1973). The leadership of 56598_CH01_0001_0024:56598_Nickitas 20 3/1/10 12:06 PM Page 20 Chapter 1: To Engage or Not Engage the agency must be in accord with the program’s goals so that it does not languish, and the personnel must also have program expertise to implement the program effectively.

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