Health Care Policy in the United States

Health Care Policy in the United States

Health Care Policy in the United States

Health Care Policy in the United States

Excerpt

As we approach the twenty-first century, the United States is at a crossroads in the development of health policy. During the I980s the appropriate role of government in social policies was debated; newly elected national leaders argued in favor of reducing the level of the federal government's involvement in resolving social (human) problems. President Reagan was outspoken in his 1980 campaign and again in 1981: he wanted the level of federal social spending reduced and federal social programs trimmed. A variety of programs have been affected by these reductionist efforts. Health care programs are especially vulnerable because they represent the largest percentage of federal social spending, except for Social Security (projections are that Medicare will overtake Social Security in monies spent in the next ten years). An era of constraint in federal spending has brought reductions in the number of beneficiaries of some programs (such as Medicaid) and increased cost sharing by beneficiaries in others (such as Medicare). Government in the I990s, however, seems once again to be focused on providing greater access to medical care by expanding eligibility in the Medicaid program and at least considering new programs to make health insurance available to those who are presently without that benefit.

This is certainly an appropriate time to ask what the commitments of government ought to be vis-à-vis the health care of its citizens. By the end of the I980s, policy analysts and government officials realized that attempts to resolve any particular problem, such as high costs, would only exacerbate other problems, such as access to care for the uninsured. We now know that there is no magic bullet that will solve all the problems in delivering and financing health care in the United States. Those problems include: containing the ever-increasing level . . .

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