The year 1982 has presented the President and the Congress with an opportunity to restructure the role of the federal government in its dealings with other levels of government and with its citizens. In health, a new era of federal-state relationships is possible, with all the old guidepost relationships established during the 1960s and 1970s becoming obsolete.
In 1982, decisions on health programs and the structure of the federal involvement in these programs will be made based on a different set of imperatives than has been the case before. Unemployment is at near-record highs. Interest rates remain high, and both the President and the Congress are predicting record-breaking peacetime budget deficits for the coming years. The Congressional Budget Office has forecast that, under current law, the federal budget deficit will reach 5% of the gross national product (GNP) in 1984. The White House, while using more optimistic assumptions, still has
Rubin RN. The New Federalism for Health: Shifting Responsibilities and Reducing Costs Into the 80s. JAMA. 1982;247(21):2911–2912. doi:10.1001/jama.1982.03320460023007
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