Health Care Policy and Regulation: Introduction

Abstract

To say that Health Care in America is changing is to grossly understate the revolution which has overtaken the delivery, financing, and regulation of American health care services during the 1990s. These changes will continue as pressures build from employers, citizens, and health care providers for changes which meet the apparently conflicting goals of Security, Simplicity, Savings, Quality, Choice, and Responsibility and as Congress grapples with developing legislation which can pass both Houses. At the same time, many states are not waiting for Congress to act, but are going ahead with their own reforms, in an effort to meet the growing health care needs of their populations. Meanwhile, a number of important developments are taking place in the private sector, as employers shift more of the cost of health benefits to employees; as managed care organizations grow larger and develop networks of associated providers; as the pharmaceutical industry undergoes a major structural change through mergers, alliances, and vertical integration; and as the hospital sector goes through a process of mergers and consolidations in an effort to resolve the problems of excess capacity and over investment in technology. Thus, even without major legislation from Washington, Health Care in America will never be the same.