Administrative burdens of health care reform explored in publication

Health Care Financing Review, Winter, 1994

When Congress eventually acts on health care reform, the plan it ultimately approves may contain an "Achilles heel" that could doom it to failure. That hidden element, according to a recently published book, is the crushing administrative burden that sweeping health reforms could impose on the agencies charged with implementation.

Congress can set policy and figure out how to pay the costs, say editors John DiIulio and Richard Nathan in Making Health Reform Work: The View from the States. However, the "Catch 22" of health care overhaul is the task of managing the program that would be dumped on Federal and especially State bureaucracies.

"Even the most incremental national plans that promise phased-in reforms but gloss over the political and budgetary realities of policy implementation are bound to get lost in the administrative maze," the editors observe. "The administrative success or failure of health care reform, in the end, will define it."

The book addresses the key roles the States must play with health alliances, cost control, quality assurance, and in restructuring the Nation's medical work force. Produced in close consultation with State health care officials from across the country, this volume offers practical and timely recommendations.

DiIulio and Nathan assert that health reform "promises to be the biggest single domestic policy innovation in American history." It is essential, they write, that a sound administrative course be set right from the beginning.

Making Health Reform Work: The View from the States is available for $29.95 in cloth (ISBN 0-8157-1852-7) or $11.95 in paperback (ISBN 0-8157-1851-9). For further information, contact Elizabeth Benevides at (202) 797-6107.