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Why did President Clinton's efforts to reform the financing of American health care fail? For years to come, politicians and scholars of public policy will revisit the debate over Clinton's health care plan. What did planners do right? And what did they do wrong? How can the mistakes of that experience be avoided in the future? What steps can now be taken to achieve some measure of reform in smaller pieces? In The Problem That Won't Go Away, economists, political scientists, sociologists, public opinion experts, and government staff offer answers to these and other crucial questions. They recount the history of the Clinton health care plan, present several alternative strategies the administration might have pursued, and conclude that none was likely to achieve the administration's goals of universal coverage and cost containment. Many support the view that the administration, Congress, and the nation lacked the political consensus and the information to credibly describe the effects of any single bill to reform the U.S. health care system. In that case, was the only option available to the administration to reach for goals far more modest than those it sought? Health care financing as a national political issue will not go away. Pressure to cut public spending to balance the budget means that medicare and medicaid will stay in the legislative spotlight; the retirement of the baby-boom generation in the beginning of the next century promises large increases in the cost of medicare; and a flood of new and costly medical technologies will continue to put financial pressure on everyone responsible for paying for health insurance. But, as this book illustrates, the nature of the debate in the years after the demise of the Clinton plan will be altogether different from that of the past several decades

The United States spends more on health care than any other nation in the world, yet millions of Americans cannot afford basic care for acute illnesses, few are insured against the costs of long-term care, and many frequently used medical procedures have never been fully evaluated. The goals of controlling spiraling health care costs and extending insurance coverage or even maintaining current insurance coverage seem to be in conflict. But progress can be made on both goals if they are tacked together. Henry Aaron evaluates these critical issues and explores how adequate care can be provided without fueling inflation. Because the current arrangements for financing America's health care cannot endure, Aaron contends that a major national debate on the restructuring of the U.S. system of financing health care is inescapable, and major legislation is likely. Serious and Unstable Condition offers a guide that is crucial to understanding the reform debate. It explains the important economic issues of health care as a background for evaluating both the current system and proposals for change. Aaron compares the U.S. system of health care financing with certain foreign systems and reviews major options for reform. He cautions that unless the health insurance system is radically changed, the number of uninsured will continue to increase and costs will continue to escalate. He then offers his own comprehensive plan to address these problems.

The social security system affects people throughout most of their lives, at work and in retirement. The supposed effects of social security on saving, labor supply, and the distribution of income figure prominently in current debates about whether and how to change the system. Theorists have developed alternative analytical frameworks for studying social security, but all involve extreme assumptions introduced for the sake of analytical tractability. Each study seems to describe the behavior of some, but not all or even most people. The shortcomings of available data have created additional roadblocks. As a result, the effects of social security on saving and labor supply are difficult to measure, and how such a complex system influences behavior is not at all well understood. Yet decisions on social security cannot be avoided. If analysts cannot agree, policymakers are likely to increase the weight they attach to perceptions of equity, adequacy of benefits, fairness of taxes, and similar qualitative considerations. Hence it is desirable for lay observers to understand the framework that analysts use and the reasons why there is so much uncertainty. This book sheds light on social security issues by examining evidence from economic studies about how the system affects saving, labor supply, and income distribution. It shows that these studies provide little evidence to support or refute assertions that social security has reduced saving, but they do indicate that it has contributed to the trend toward early retirement. The author finds that the aged are now about as well off on the average as the general population and that social security has played a considerable role in bringing about this equality. This volume is the sixteenth in the second serioes of Brookings Studies of Government Finance.

This article theorizes the relationship of privacy to capital and projects of security and, in doing so, situates privacy in context to pacification. In particular, the article provides an interrogation of the contradictory structuring of privacy as both an object threatened by security and the role of privacy as a means to resist or limit projects of security. Through an analysis of Thomas Hobbes’ writings, this contradictory dual-deployment of privacy is unseated to reveal that far from challenging security, privacy has historically been presupposed and structured by security projects. Moreover, by acclimatizing us to our existence as atomized individuals, alienated from our collective social power, privacy in fact pacifies us. This process is explored through an examination of the Passenger Flight List agreement (PNR) between the United States and EU member states. The article concludes with a brief discussion of the implications of our reliance on privacy has for challenging the logics of security and pacification, especially with the emergent technology of Drones.

Although Kristol's book is vastly better than Devine's--both in style and in content--the two books suffer from a common short-coming. Kristol sees a central institution of modern capitalism--the corporation-under aggressive attack, and seeks to defend it. One may disagree with his appraisal of the risks, and resent his tendency to tar all critics with the inanities of the most extreme, but he has a strong case to make-that the rise of modern American capitalism has been a magnificent success story. This success has required an uneasy cooperation between free-market institutions and collective restraints and modifications of market outcomes. By seeing evil in critics of some of the workings of the American economy and over-simplifying complex problems, Kristol fails to contribute to under-standing the nature of this partnership. Devine all but denies that there is such a partnership. But such a partnership indubitably exists, even if one yearns for a simpler world in which it would not be necessary. Those who would deny any constructive role for collective action and those at the other end of the political spectrum who deny the accomplishments and strengths of the market economy both retard the needed discussion on whether the balance between these two elements of the partnership is correct and how it should be changed in specific instances. Unfortunately, both Kristol and Devine obstruct such a discussion and instead tend to polarize complex questions from one particular point of view.

"Examines the use of rationing as a means to curb health care spending, using the experience of Great Britain to highlight the promises and pitfalls of this approach"--Provided by publisher