PMID: 9005259Jan 15, 1997Paper

Health reform for the 21st century? It may have to wait until the 21st century

JAMA : the Journal of the American Medical Association
P P Budetti

Abstract

To assess the likelihood of health care legislation in the forthcoming 105th Congress in 5 areas: health care coverage, tax and Employee Retirement Income Security Act (ERISA) policy, Medicaid, Medicare, and managed care. Informal, semistructured conversations that took place in the months prior to the 1996 elections. Congressional health staff and administration officials. Unofficial, off-the-record personal opinions. Health care coverage initiatives to benefit children and unemployed persons are likely to be proposed, but have little chance of enactment; children are seen as well provided for under current Medicaid law, the strong economy and high employment levels lower concern for unemployed issues, and the effort required to pass the Kassebaum-Kennedy legislation needs time to settle. Tax proposals, such as medical savings accounts (MSAs), and ERISA amendments have no constituency; also, the MSA demonstration in Kassebaum-Kennedy will forestall further action. Medicaid is far less an issue than in the previous Congress, because spending has fallen unexpectedly, the bitter fight over block grants makes them unlikely to be revisited, and the administration is likely to enhance state flexibility through waivers. Medicare will...Continue Reading

Citations

Feb 19, 1998·The New England Journal of Medicine·P P Budetti
Jun 6, 1998·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·C H EllenbeckerM Kane
Jul 31, 2004·Sociology of Health & Illness·Pascale LehouxLucie Richard
Jun 1, 2007·Journal of Medical Internet Research·Claudia Pagliari
Jul 3, 2008·FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology·Gerald Weissmann

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