‘개혁의 법칙’을 넘어? 2009~2010 미국 의료보험 개혁의 정치

This paper analyses how the health care reform in the US in 2009-2010 became possible focusing on the interests and strategic interaction among the key social and political actors. Major theories on the politics of welfare give lucid explanations as to why a comprehensive health care reform has been so difficult in the US. However they are weak in analysing how the reform became possible. This study explains the health care reform in 2009-10 as a product of power relations between the stakeholder coalition and stake challenger coalition adopting a revised version of action-oriented power resource theory. The reform became possible, since the strategic action of the stake challenger coalition could create the balance of power to overcome the opposition of the stakeholder coalition Such results reveals that power ‘relations’ of the confronting coalitions, rather than power resources of individual major actors, are crucial in changes of welfare policies.