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November 8, 1995

Health System DeregulationSome Aspects of Health Care System Reform Need Not Be Held Hostage

Author Affiliations

From Mercy Clinics, Inc, Des Moines, Ia; Department of Family Medicine, Mayo Medical School, Rochester, Minn; and Office of the Chairman, National Health Policy Council, Washington, DC. Dr Gleason is a former White House Advisor and Senior Consultant to the Department of Health and Human Services.

JAMA. 1995;274(18):1483-1486. doi:10.1001/jama.1995.03530180077044

What a difference a year can make. During the summer of 1994, Washington was completely consumed by the congressional debate over health care system reform. The tides have ebbed and this issue has been at least temporarily swept into the recesses of the Capitol corridors. The 104th Congress is not expected to enact any comprehensive health system reform, and the attention of most health care lobbyists has been diverted to preventing deep Medicare and Medicaid cuts. While sharp divisions emerged in the last 12 months over health system reform, there is bipartisan support for decreasing paperwork and reducing the oppressive regulatory health care environment. Administrative simplification should move forward.

Efforts to streamline the existing health care bureaucracy in the public and private sectors can be accomplished in many cases without new legislation. This article outlines examples of such initiatives.

The following proposals are based, in part, on a report prepared

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