Cost pressures and health policy reform.

Abstract

Prologue: When Democrat James Jones emerged as chairman of the House Budget Committee in 1980, he solidified a growing reputation as a forceful policymaker, an eminence that helps him in Tulsa, the center of a solidly Republican district he has represented since 1972. As a White House staff assistant to President Johnson before he was thirty, Jones has come to know the corridors of power, though he is neither a conventional Democrat nor a legislator who always follows in lockstep the directions of his party's House leadership. Philosophically, Jones believes that the mechanisms of free-market competition produce economic growth more readily than government spending. Jones is inclined to believe that we need more, not less, defense spending, although he stood up for social spending as Budget Committee chairman in a more aggressive fashion than some of his colleagues anticipated. Jones, a senior member of the House Ways and Means Committee who often finds himself at odds with the panel's chairman, takes an active role in trade issues. On the key Ways and Means panel, Jones often joins with other younger members, Democrats and Republicans, to press alternatives to traditional Democratic economic positions. Jones's new emphasis in health legislation is a bill that would seek to control consumer health expenses in two ways: first, it would seek to insure all Americans against catastrophic medical expenses and, secondly, it would strive to reduce the rate of inflation for health care expenses by discouraging overinsurance and overutilization of health care. Jones's interest in health issues is something of an anomaly. He is not a member of the Ways and Means Subcommittee on Health, nor does he have anything to gain politically from his involvement, given the steps of retrenchment the government is taking to resolve its budget problems. Perhaps his activity can best be characterized as a demonstration of leadership at a time when many policymakers are running for cover.