Smith MD. States and Health Care Reform—Laboratory, Stepping Stone, or Stumbling Block? JAMA Forum Archive. Published online November 1, 2012. doi:10.1001/jamahealthforum.2012.0067
“All politics is local” is a maxim coined by Thomas “Tip” O’Neill, former Speaker of the US House of Representatives, and most people probably think that’s a good thing and a key feature of our democracy. And, of course, most people know that “all health care is local.” So even though the fate of the Patient Protection and Affordable Care Act (ACA) is being debated on a national stage today, the future of health reform is likely to take on a local flavor, no matter who prevails on November 6.
Indeed, what states do or do not do—and how well they do it—will largely determine how well the ACA achieves its goals. In the case of health care, whether this reliance on state variation promotes or retards the rapid reformation of our health care system is an open question.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.