Setting National Priorities: The 2000 Election and Beyond

Brookings Institution Press
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"If the subject of influence in Washington interests you, this series of books deserves your respectful attention...it has changed the ways in which American politicians think about the budget." - The Washington Post For the first time in more than four decades, the federal budget has registered two consecutive surpluses, and the need to reduce the deficit is not casting a pall over the policy debate. This new, highly accessible book examines the policy options that are available in this new environment to address the new and recurring challenges that face the nation. The book, which continues the Brookings Institution's highly acclaimed and influential Setting National Priorities series, will serve as a guide for understanding many of the complex issues that will be discussed during the presidential and congressional campaigns of 2000. The book centers around three themes: providing opportunity in the domestic arena, restoring confidence in government, and adapting to the post-Cold War international environment. It tackles such critical issues as Medicare and social security, tax reform, and foreign policy spending, as well as many areas not included in previous editions; namely, education, urban problems, the environment, trade, government renewal and reform, crime and drugs, and families. In addition to the editors, the contributers are Gary Burtless, I. M. Destler, John J. DiIulio Jr., William Gale, Bruce Katz, Donald F. Kettl, Paul C. Light, Thomas E. Mann, Michael O'Hanlon, Paul R. Portney, Diane Ravitch, Isabel V. Sawhill, and James Sly.
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About the author

Henry J. Aaron is a senior fellow in Economic Studies at the Brookings Institution, where he holds the Bruce and Virginia MacLaury Chair. Among his many books are Can We Say No? The Challenge of Rationing Health Care, with William B. Schwartz and Melissa Cox (Brookings, 2006), and Reforming Medicare: Options,Tradeoffs, and Opportunities, written with Jeanne Lambrew (Brookings, 2008). Robert D. Reischauer was a former director of the Congressional Budget Office.

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Additional Information

Publisher
Brookings Institution Press
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Published on
Jul 1, 2011
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Pages
516
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ISBN
9780815719465
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Language
English
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Genres
Political Science / International Relations / General
Political Science / Political Process / Campaigns & Elections
Political Science / Public Policy / City Planning & Urban Development
Political Science / Public Policy / Economic Policy
Political Science / Public Policy / Social Policy
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Content Protection
This content is DRM protected.
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In the early 1960s America was in a confident mood and embarked on a series of efforts to solve the problems of poverty, racial discrimination, unemployment, and inequality of educational opportunity. The programs of the Great Society and the War on Poverty were undergirded by a broad consensus about what our problems as a nation were and how we should solve them. But by the early seventies both political and scholarly tides had shifted. Americans were divided and uncertain about what to do abroad, fearful of military inferiority, and pessimistic about the capacity of government to deal affirmatively with domestic problems. A new administration renounced the rhetoric of the Great Society and changed the emphasis of many programs. On the scholarly front, new research called into question the old faiths on which liberal legislation had been based.

In this book, the sixteenth volume in the Brookings series in Social Economics, Henry Aaron describes both the initial consensus and its subsequent decline. He examines the evolution of attitude and pronouncements by scholars and popular writers on the role of the federal government and its capacity to bring about beneficial change in three broad areas: poverty and discrimination, education and training, and unemployment and inflation. He argues that the political eclipse of the Great Society depended more on events external to it—war in Vietnam, dissolution of the civil rights coalition, and, finally, the Watergate scandal and all its repercussions—than on its intrinsic failings. Aaron concludes that both the initial commitment to use national polices to solve social and economic problems and the subsequent disillusionment of scholars and laymen alike rest largely on preconceptions and faiths that have little to do with research themselves.

Academic medical centers provide cutting edge acute care, train tomorrow's physicians, and carry out research that will expand the range of treatable and curable illnesses. But these centers themselves may need urgent care—experts generally agree that many are suffering acute—even life-threatening—financial distress. Many academic medical centers are suffering for several reasons: in-patient admissions are down, as many procedures that once required a hospital stay are now performed on an out-patient basis or in a physician's office ; managed care plans have negotiated discounted fees that cut hospital operating margins; the Balanced Budget Act of 1997 curtailed Medicare reimbursements, lowered margins and pushed some into the red; the revolution in information technology is imposing large new capital costs; and the character of medical education is receiving its most thorough review in decades. While there is a general consensus that medical centers are under pressure, experts disagree about the depth and pervasiveness of the current financial distress. Are they whining about financial pressures other, less-favored sectors find routine; or is the high quality American teaching hospital becoming an endangered species—that could face extinction if nothing is done. Because academic medical centers perform such important jobs, it is critical to determine the true nature and depth of their current financial problems—and then fashion analytically sound and politically sustainable solutions. This book brings together chief executive officers of major medical centers, university presidents, senior members of Congressional and executive office staffs, and leading analysts. These experts address the key issues and prescribe remedies both regulatory and legislative to ensure that the teaching hospital remains a picture of financial health. Contributors include Nancy Kane (Harvard School of Public Health), Jamie Reuter (Institute for Health Care Research Policy, Georgetown University), Peter van Etten (Juvenile Diabetes Foundation), Ralph Muller (University of Chicago Hospitals and Health System), James Robinson (School of Public Health, University of California, Berkeley), David Blumenthal (Institute for Health Policy, Massachusetts General Hospital), Edward Miller (Johns Hopkins University School of Medicine), Spencer Foreman (Montefiore Medical Center), Lawrence Lewin (Lewin Group), Gail Wilensky (Project HOPE), Robert Dickler (American Association of Medical Colleges), and Kenneth Shine (Institute of Medicine).
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