Michael D Reagan - The Accidental System. Health Care Policy in America

The Accidental System

The Accidental System

Dilemmas in American Politics

Series Editor L. Sandy Maisel,Colby College

Dilemmas in American Politics offers teachers and students a series of quality books on timely topics and key institutions in American government. Each text will examine a real world dilemma and will be structured to cover the historical, theoretical, policy relevant, and future dimensions of its subject.

EDITORIAL BOARD

Jeffrey M. Berry

Tufts University

John F. Bibby

University of WisconsinMilwaukee

David T. Canon

University of WisconsinMadison

Rodolfo O. de la Garza

University of TexasAustin

Diana Evans

Trinity College

Linda L. Fowler

Dartmouth College

Paul S. Herrnson

University of MarylandCollege Park

Ruth S. Jones

Arizona State University

Paula D. McClain

University of Virginia

Karen OConnor

American University

Samuel C. Patterson

Ohio State University

Ronald B. Rapoport

The College of William and Mary

Craig A. Rimmerman

Hobart and William Smith Colleges

Larry Sabato

University of Virginia

David Shribman

The Boston Globe

Walter J. Stone

University of ColoradoBoulder

BOOKS IN THIS SERIES

The Accidental System: Health Care Policy in America, Michael D. Reagan

The Image-Is-Everything Presidency: Dilemmas of

American Leadership, Richard W. Waterman, Robert Wright, and Gilbert St. Clair

Can We All Get Along? Racial and Ethnic Minorities in

American Politics, Second Edition, Updated, Paula D. McClain and Joseph Stewart Jr.

The Dysfunctional Congress? The Individual Roots of an Institutional Dilemma,

Kenneth R. Mayer and David T. Canon

Checks & Balances? How a Parliamentary System

Could Change American Politics, Paul Christopher Manuel and Anne Marie Cammisa

Remote and Controlled: Media Politics in a Cynical Age, Second Edition,

Matthew Robert Kerbel

The Angry American: How Voter Rage Is Changing the Nation, Second Edition,

Susan J. Tolchin

Two PartiesOr More? The American Party System,

John F. Bibby and L. Sandy Maisel

Making Americans, Remaking America:

Immigration and Immigrant Policy,

Louis DeSipio and Rodolfo O. de la Garza

From Rhetoric to Reform?

Welfare Policy in American Politics,

Anne Marie Cammisa

The New Citizenship: Unconventional Politics, Activism, and Service,

Craig A. Rimmerman

No Neutral Ground? Abortion Politics

in an Age of Absolutes, Karen OConnor

Onward Christian Soldiers? The Religious Right

in American Politics, Clyde Wilcox

Payment Due: A Nation in Debt, A Generation in Trouble,

Timothy J. Penny and Steven E. Schier

Bucking the Deficit: Economic Policymaking in the United States,

G. Calvin Mackenzie and Saranna Thornton

Dilemmas in American Politics

All rights reserved. Printed in the United States of America. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the publisher.

Copyright 1999 by Westview Press, A Member of the Perseus Books Group

Published in 1999 in the United States of America by Westview Press, 5500 Central Avenue, Boulder, Colorado 80301-2877, and in the United Kingdom by Westview Press, 12 Hids Copse Road, Cumnor Hill, Oxford OX2 9JJ

Library of Congress Cataloging-in-Publication Data

Reagan, Michael D.

The accidental system : health care policy in America / Michael D. Reagan.

p. cm. (Dilemmas in American politics)

Includes bibliographical references and index.

ISBN 0-8133-9997-1 (hc). ISBN 0-8133-9996-3 (pbk.)

1. Medical policyUnited States. 2. Medical careUnited States.

I. Title. II. Series.

RA395.A3R36 1999

362.1'0973dc21

98-55763

CIP

The paper used in this publication meets the requirements of the American National Standard for Permanence of Paper for Printed Library Materials Z39.48-1984.

10 9 8 7 6 5 4 3 2