| Popis: |
While most commentators decry our peculiar ability to combine insecurity with high cost, the substantial reform of American medicine at the national level has been enormously difficult to achieve, and comprehensive reform has been impossible. This is not simply a description of the Clinton Health Plan debacle of 1993–1994. On many occasions before and after the Second World War, comprehensive national reform was attempted (and in 1973–1974, appeared imminent). In all those instances, reform fell short of the necessary political majorities. Each of these failures has its own history, and in each there are many contributing causes. One fact remains: Americans have long been dissatisfied with the nation's medical arrangements, but our political system has been unable to come up with a solution that satisfies enough of the public to overwhelm the institutional and interest group barriers to reform. |
