Transforming national health policy: The significance of the stratification system

Policy formulation and decision-making occur within a continually changing sociopolitical environment. Presently, our national health policy lacks coherence and direction. It also is in a state of transition as evidenced by the recent restricted proposal to expand Medicare coverage to catastrophic illness. A comprehensive strategy for balancing escalating medical, hospital, and insurance costs as well as those associated with long-term care while extending access has not been devised. One of the most salient reasons for this is the failure of policy makers to grasp the complexities of the multifaceted stratification system. Its diverse, interrelated strata based on age, sex, economic status, and race are not incorporated in the process of shaping vitally needed and rational health policy. Doris Y. Wilkinson, a professor of sociology at the University of Kentucky, is a co-principal investigator on an intervention project funded by the National Cancer Institute. She recently received the Master of Public Health in Health Policy and Management from Johns Hopkins University.