University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Baker Center: Publications and Other Works Baker Center for Public Policy Fall 2008 Baker Center Journal of Applied Public Policy, Vol. II No. I Howard H. Baker Jr. Rita Sanders Geier Connie Ditto Beth Lauck Rebecca McClintock See next page for additional authors Follow this and additional works at: https://trace.tennessee.edu/utk_bakecentpubs Recommended Citation Baker, Howard H. Jr.; Geier, Rita Sanders; Ditto, Connie; Lauck, Beth; McClintock, Rebecca; Lynch, Ed; Asingo, Patrick O.; and Wilson, Elizabeth M., "Baker Center Journal of Applied Public Policy, Vol. II No. I" (2008). Baker Center: Publications and Other Works. https://trace.tennessee.edu/utk_bakecentpubs/4 This Article is brought to you for free and open access by the Baker Center for Public Policy at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Baker Center: Publications and Other Works by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. Authors Howard H. Baker Jr., Rita Sanders Geier, Connie Ditto, Beth Lauck, Rebecca McClintock, Ed Lynch, Patrick O. Asingo, and Elizabeth M. Wilson This article is available at TRACE: Tennessee Research and Creative Exchange: https://trace.tennessee.edu/ utk_bakecentpubs/4 vol. 1i no. 1 1i no. vol. Baker CENTER JOURNAL OF APPLIED BAKER CENTERAPPLIED POLICY PUBLIC JOURNAL OF Public policy Published by Howard H. Baker Jr. Center for Public Policy at the University of Tennessee, Knoxville ARTICLES Introduction to the Baker Center Journal of Applied Public Policy ...................................................... 1 The Honorable Howard H. Baker, Jr. Call to Action: A Federal Assault on Health Inequity ............................................ 2 Rita Sanders Geier Policy Considerations for Long-TermCare: Cost, Quality & Access ...........................................................26 Connie Ditto Beth Lauck Rebecca McClintock “The Monster that Ate Nashville”: TennCare and the Future of Government Health Care ...............41 Ed Lynch Policy Salience and Voter Turnout: An Analysis of Contemporary U.S. Presidential Elections ...........52 Patrick O. Asingo STUDENT ARTICLES fall 2008 fall Public Policy and New Destination Latino Immigration .............................................................68 Elizabeth M. Wilson Howard H. Baker Jr. Center for Public Policy The University of Tennessee • 217 Hoskins Library • Knoxville, TN 37996-4014 865-974-0931 • 865-974-8777 (fax) • www.bakercenter.utk.edu • e-mail: [email protected] baker Center JOURNAL OF TheBaker Center Journal of Applied Public Policy is published semiannually by the Howard H. Baker Jr. Center APPLIED for Public Policy at the University of Tennessee, Knoxville. Manuscript submission, books for review, and any correspondence regarding this journal should be addressed public policy to Editorial Office, Howard H. Baker Jr. Center for Public Policy, 217 Hoskins Library, Knoxville, TN vol. 1i no. 1 | fall 2008 37996-4014 (telephone: 865-974-0931, fax: 865-974-8777, e-mail: [email protected], web site: www. bakercenter.utk.edu). Journal Advisory Board The vision of the Baker Center Journal of Applied Public Policy is to provide public officials, policymakers, Hon. Howard H. Baker, Jr. political activists, scholars, and citizens with forward-looking commentary and research on matters of public policy. The journal will focus on pragmatic, rather than theoretical, analysis of issues that are regional, national, formerly of the United States Senate and international in scope. Hon. Bob Clement formerly of United States House of Representatives The Baker Center Journal of Applied Public Policy will publish articles, essays, and book reviews Dr. Joseph Cooper semiannually with direction provided by a national advisory board made up of distinguished scholars and public-policy leaders. The journal’s editorial board comprises preeminent faculty members, practitioners, Department of Political Science, Johns Hopkins University and graduate students in law and political science as well as from selected undergraduate members of the Dr. Michael R. Fitzgerald university’s Baker Scholars honor society. Department of Political Science, University of Tennessee, Knoxville Alan C. Lowe Executive Director, Howard H. Baker Jr. Center for Public Policy Hon. Emily Reynolds formerly the Secretary of the United States Senate Glenn Harlan Reynolds Submission Requirements College of Law, University of Tennessee, Knoxville John Seigenthaler The Baker Center Journal of Applied Public Policy seeks manuscripts that explore topics across the First Amendment Center, Vanderbilt University policy spectrum. We generally seek manuscripts that are between 10 and 30 double-spaced typewritten pages, including endnotes. Editorial Board The Baker Center Journal of Applied Public Policy accepts articles electronically or in hard-copy format Bryce W. McKenzie Staff Editors with a diskette or CD-ROM included. Manuscripts may be mailed to the Baker Center or they may be e-mailed to the editorial staff at with “Journal Article” in the subject line. All submitted Editor in Chief Sarah Bounse [email protected] Jill M. Shotzberger manuscripts should be double spaced in a 12-point font with 1-inch margins and saved in MS Word or a text Mary Braddock format. The journal will publish articles that contain endnotes in accordance with either APA style or with Managing Editor Laura Beth Brown the 18th edition of The Bluebook. However, all articles that focus primarily on legal issues should contain Bradford A. Vaughan endnotes in accordance with The Bluebook. Executive Editor Christian Cooper Connie S. Ditto Thank you for your interest. Please direct any questions to Dr. Michael R. Fitzgerald, Faculty Editor, at [email protected], or Dr. Nissa Dahlin-Brown, Associate Director, at [email protected]. Alexandra Hansen Research Editors Michael Haynes Michael S. Lumley Jason Hubbard Raymond G. Lewallen Erik Krag Lane McCarty Eric Mauldin Baker Center Journal of Applied Public Policy Elizabeth M. Wilson Jennifer E. Miller Published by the University of Tennessee Howard H. Baker Jr. Center for Public Policy Amit Dhiru Patel vol. 1i no. 1 fall 2008 Maria Rahman Copyright © 2008 by the UNiversitY OF TENNessee The UNIVERSITY OF TENENSSEE is an EEO/AA/Title VI/Title IX/Section 504/ADA/ADEA Thomas W. Whitworth institution in the provision of its education and employment programs and services. PA #R01-0130-010-001-09. Ashley L. White i ii Introduction to the BAKER CENTER JOURNAL OF APPLIED PUBLIC POLICY elcome to the second issue of the Baker Center Journal W of Applied Public Policy. I am very proud of this publication for many reasons. First, it continues to fulfill the mission that I stated in our inaugural issue: the research and discussion of applied public policy issues. Second, it has been put together by a resourceful set University Administration of University of Tennessee students, aided by Baker Center guidance and by our national board of advisors. It is refreshing to witness their Dr. John D. Petersen dedication and determination. Lastly, the Journal is central to our vision President for the Howard H. Baker Jr. Center for Public Policy at the University of Tennessee. The Center has established itself over the past five years as Dr. Jan F. Simek a leader in discussing, researching, and teaching about critical public Interim Chancellor policy topics as well as encouraging civic awareness and engagement. I am very pleased with its success and happy that, as part of its mission, it Dr. Susan D. Martin Interim Provost oversees the creation of this excellent publication. Howard H. Baker Jr. Center for Public Policy Alan C. Lowe Executive Director and Journal Advisor Dr. Michael R. Fitzgerald Senior Teaching Fellow, Dept. of Political Science and Journal Editor Dr. Nissa Dahlin-Brown Associate Director and Journal Production Manager Bobby Holt Director of Archives and Research D. Gavin Luter Coordinator Justin Eastwood Archives Coordinator Patti Rebholz Administrative Specialist Rachel Berghorst Administrative Assistant and Journal Production Assistant Howard H. Baker Jr. Center for Public Policy iii 1 Call to Action: A Federal Assault on Health Inequity Rita Sanders Geier, University of Tennessee, Knoxville The Current Crisis We all know the problem: the alarming disparities in American health care and health status is a crisis that has been well-documented and widely debated. Schol- ars, politicians, and health care professionals have long recognized the crippling reality and destructive impact of inequities in this most fundamental of human rights. It is a crisis that not only impacts the credibility of our national promise of life, liberty, and the pursuit of happiness, but a pervasive problem with many dif- ferent faces: disparities based on race, ethnicity, geography, socio-economic status, gender, and sexual orientation. It has a spectrum of manifestations, from basic lack of access to health care and unequal quality of care, to disturbing differences in health outcomes. Health inequity has compelling moral and ethical implications as well as clear economic and social impacts. The consequences of the status quo are unacceptable. This spring, as we celebrate the legacy of Dr. Martin Luther King, Jr., we would do well to recall his words, that “of all forms of inequity, injustice in health care is the most shocking