Intergovernmental issues raised by the national health planning program

Raab uses the National Health Planning and Resources Development Act of 1974(P.L.93-641)which designated state and substate regional planning agencies, as a departure for discussion of a larger issue: federalism. Administration of the law has raised issues about the allocation of power among national, state and local governments. The author tries to set this question in historical context by tracing the history of U.S. intergovernmental relations and highlighting key issues. He focuses on two perspectives of federalism: cooperative and competitive relations between governments. From this survey, Raab draws three conclusions: conflict has become "inevitable" as governments pursue their own objectives in administering national grants-in-aid; state and local officials have grown more concerned with administrative structure than the substance of policy; and the growth of lobbies for state and local governments has reduced the prospect of conflict.