Expertise and the Enigma of Policy Influence : How Interventions in Healthcare and Education Changed Economics, 1950-2023

This dissertation is the first comparative history of the role economists have played in healthcare and education policy in the United States. It is often assumed that in the realm of social policy, economics has been something of a hegemonic juggernaut led by elite thinkers, but this study demonstrates the unfolding of a more malleable field being steadily remade by lesser-known experts. Drawing on historical developments beginning in the 1950s, the project analyzes the role economics plays as social programs are designed, implemented, and evaluated; and, in turn, how the field is reshaped by this role. It follows the course by which applied methods come to eclipse reverence for economic theory, and research design itself becomes a central object of study for only some at the discipline’s core. Debunking the notion that economics has been engaged in a continuous march toward domination in social policy, it demonstrates that the influence of economics is not necessarily most momentous when conducted prospectively based on theory, but rather in an iterative fashion in which evidence is gathered on the basis of prior policy change, and then used to inform subsequent policy design: policy-based evidence, not evidence-based policy. This work better equips us as a society to rethink the enormously consequential economics of social policy.