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Devolution of power: an interim report card
1Columbia University School of Public Health, New York City, USA.
Health Affairs (Project Hope)
|June 25, 1998
Summary
States struggle to expand health insurance and control costs without federal support. Recent federal legislation for child health and insurance reform is a welcome and overdue development.
Area of Science:
- Health Policy
- State Government
- Healthcare Management
Background:
- In the mid-1990s, states were expected to lead in health insurance expansion and cost containment.
- Divergent goals existed: liberals focused on coverage, conservatives on cost control.
Purpose of the Study:
- To evaluate state performance in key healthcare policy areas.
- To determine if states can meet expectations for health insurance and cost containment independently.
Main Methods:
- Review of state performance in four critical policy areas.
- Analysis of initiatives in Medicaid managed care, children's insurance, small business affordability, and long-term care costs.
Main Results:
- States face significant challenges in achieving healthcare goals without federal assistance.
- Federal intervention is necessary for effective state-level health policy implementation.
Conclusions:
- State-led healthcare reforms are insufficient without federal partnership.
- Recent federal legislation signifies a positive and necessary shift towards national health policy coordination.