The role of state and local government in health.

Abstract

Prologue: As a consequence of the taxpayer's revolt that began in California and spread across the country, sharp cutbacks in federal aid to subnational levels of government, and the economic recession, state and local governments are being forced to cope with dramatically reduced resources. Nevertheless, spending for health remains big business in state and local governments today. More than one of every six dollars states spend (16.9percent) are devoted to health, slightly more than the share of the federal budget devoted to health (13 percent). Local governments spend 7.8 percent of their overall expenditures for health purposes, a proportion roughly equal to that of transportation, public safety, and natural resources and more than spending for public welfare. Recognizing that resources are shrinking at a time when responsibilities are expanding, Drew Altman and Douglas Morgan have a particular interest as officers at The Robert Wood Johnson Foundation in developing policy approaches to this difficult...