Joseph White

Case Western Reserve University
Political Science

Case Western Reserve University Mather House 111
11201 Euclid Avenue
Cleveland, OH

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My work has focused on federal budgeting policy and politics, health policy and politics both in the U.S. and across the advanced industrial democracies, entitlement or social insurance policy and politics in the United States, and policies to control health care spending. One theme of my work is to be careful about the scale of effects: for example, the econometric evidence about the relationship between budget balances and economic growth does not support strong policy prescriptions. Another is to define problems carefully: thus the health care costs associated with population aging in the U.S. are exaggerated if you focus on our federal budget rather than on society, which is an artifact of having Medicare and Medicaid but not having national health insurance. A third is to recognize limitations on knowledge and institutional capacity. My publications include three books and over 70 articles and book chapters. A series of articles both before and after passage of the 2010 health care legislation discussed policy choices regarding cost control, reasons the legislation passed in the form it did, and how the outcomes compare to other nations' arrangements. Another set of chapters and articles since about 2008 has addressed federal budgeting, especially the presidential budget and, most recently, earmarks. I also participated in the OECD's project on the Fiscal Sustainability of Health Systems, with two journal articles and a chapter in the book that was published in September of 2015. I am currently writing a book about U.S. federal budgeting.

White, Joseph. 2011. "Prices, Volume, and the Perverse Effects of the Variations Crusade." Journal of Health Politics, Policy and Law 36: 775-90.
Abstract: This article argues that the health policy world's fixation on volume as a cause of excess spending, which in part relies on the great prestige of the "variations" line of research, is both misguided and misleading. It is misguided because some of the most prestigious data analysis in the variations literature is flawed, and the policy analyses derived by those scholars is not justified by their findings. It is misleading in the sense that it greatly influenced politicians as they considered measures to limit spending as part of the 2009-10 health care reform battle, and so led them to promote measures that CBO rightly projected were unlikely to work.
White, Joseph. 2012. "Playing the Wrong PART: The Program Assessment Rating Tool and the Functions of the President's Budget." Public Administration Review 72: 112-20.
Abstract: The experience of the second Bush administration's "PART" process adds to the long history of failed efforts at "program budgeting." It reveals the core problem at the heart of all such efforts. Budget processes can pursue efficiency within programs, focusing on ensuring each program uses its resources well. Instead, program budgeting focuses on the portfolio of programs, seeking to make the mix of programs more efficient. This requires programmatic comparisons for which no credible technique exists, and the PART process, by relying on individual judgments by often-inexperienced OMB examiners, did not solve this credibility problem.
White, Joseph. 2013. "Budget-makers and Health care systems" Health Policy (2013)
Abstract: Health programs are shaped by the decisions-made in budget processes, so how budget-makers view health programs is an important part of making health policy. This article reviews the pressures on and attitudes of the two types of budget-makers, namely political authorities and budget professionals. It explains how seemingly shared perspectives between budget professionals and health policy experts lead to more discussion than action, while action is best explained by the need to minimize blame.
White, Joseph. 2003. "Three Meanings of Capacity: Why the Federal Government is Most Likely to Lead on Health Insurance Access Issues." Journal of Health Politics, Policy and Law 28 (2-3).
White, Joseph. 2007. "Markets and Medical Care: The United States, 1993-2005." The Milbank Quarterly 85 (3): 395-448.

Substantive Focus:
Economic Policy SECONDARY
Health Policy PRIMARY
Comparative Public Policy

Theoretical Focus:
Agenda-Setting, Adoption, and Implementation SECONDARY
Policy Analysis and Evaluation PRIMARY