There is a remarkable consensus that the American
medical care system needs a major overhaul. The critical unanimity on this
point bridges almost all the usual gaps-- between old and young, Democrats and
Republicans, management and labor, the well paid and the low paid. We spend
more and feel worse than our economic competitors, with nine out of ten
Americans telling pollsters health care requires substantial change. This is
the good news for medical reformers in the Clinton administration and the
Congress.
The bad news is that, for a variety of ideological, economic, and
institutional reasons, our politics have frustratingly failed to coalesce around
