Abstract
AS HEALTH care reform on the national level moves from the theoretical to the political (as it has already done in a number of states), much of the meat of the matter remains to be determined. Although some actions seem inevitable, others do not. Furthermore, some trends will continue regardless of the direction of reform—unless it takes a truly radical turn, which is unlikely. And along the way are intersections where collisions await: between theory and practice, between the federal government and the states, between the public sector and the private sector, between Congress and the White House (and quite possibly between those two and the US Supreme Court). There is also the element of chance, which has played a major role, at times, in American public policy. The untimely death of Sen John Heinz (R, Pa), resulting in the special election that sent Sen Harris Wofford (D, Pa) back
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