The politics of health reform: why do bad things happen to good plans?
This paper examines political feasibility and its implications for health reform. I discuss the political obstacles to health reform in the United States, disentangling perennial barriers from contemporary constraints. I then explore major reform options and their political prospects. I argue that while incremental reform now appears to be the most feasible option, the political climate may change in a way that permits a bolder vision. Moreover, incremental reform may not be sustainable in the long run, for the same reason that makes it politically popular now: It does not change the status quo in the health system.
Oberlander
Jonathan
J
University of North Carolina at Chapel Hill, USA. oberland@med.unc.edu
D003363:Cost Control; D005240:Feasibility Studies; D018166:Health Care Reform; D009310:National Health Insurance, United States; D011057:Politics; D014481:United States; D019472:Universal Health Insurance