Abstract
The demise of the movement toward major federal health system reform legislation leaves us facing two stark realities. First, many of the widely recognized problems of our health care system will remain with us. Second, the failure of our political system, after 2 years of public and legislative debate, to enact any version of comprehensive legislation suggests it is unlikely to do so in the near future. This legislative impasse has major implications for what will happen in the years ahead. See also p 242. We highlight briefly the problems we expect to persist as a result of the national failure to develop comprehensive reform. We then suggest alternative strategies for incremental reform, distinguishing between those issues easily and those not so easily resolved in our emerging political environment. We can expect in the near term the following: The number of Americans without health insurance will remain high. Just last
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