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Exceeding $2 trillion annually, health care spending in the United States is growing significantly faster than the national economy. If left unchecked, this health spending crisis will threaten Americans' ability to pay for other essential services. Driven primarily by the cost of benefits promised to seniors under Medicare and Medicaid, federal health expenditures will force lawmakers to make stark policy decisions. In this third volume of Restoring Fiscal Sanity, policy experts suggest ways to slow the growth of federal spending on health care. Unless federal health spending can be brought under control, Americans will face substantially higher taxes, sharp reductions in other government programs, and cuts in benefits to the elderly. Families, businesses, and communities will be forced to make agonizing choices between health care and other needs. Focusing on policies that do not shift costs to the states or the private sector, the authors of Restoring Fiscal Sanity 2007 suggest reforms in federal programs that have the potential to reduce the growth of spending for the entire health system, increase the efficiency and effectiveness of the care provided, and enhance health outcomes. Drawing on years of government and public policy experience, they stress the need for innovative approaches and cooperation between the private and public sectors.
The United States is standing at a critical juncture in its fiscal outlook. After experiencing a brief period of budget surpluses at the turn of the century, the federal government will run deficits that add about $4 trillion to the national debt over the next decade. Substantial deficits will likely continue long into the future because the looming retirement of the baby boom generation will raise spending in Social Security, Medicare, and Medicaid. At the same time, the federal government appears to be neglecting spending in key areas of social and economic policy. The nation thus faces a vital choice: continue down a path toward future fiscal crisis while under investing in critical areas, or increase resources in high-priority areas while also reducing the overall budget deficit. This choice will materially affect Americans' economic status and security in the immediate future as well as over long horizons. In R estoring Fiscal Sanity, a group of Brookings scholars with high-level government experience provide an overview of the country's likely medium- and long-term spending needs and the resources available to pay for them. They propose three alternative fiscal paths that are more responsible than the current path. One plan emphasizes spending cuts, the second emphasizes revenue increases, and a third is a balanced mix between the two. The contributors address the policy choices in such areas as defense, homeland security, international assistance, and programs targeted to the less advantaged, the elderly, and other domestic priorities. In the process, they provide an understanding of the short- and long-run trade offs and illustrate how the budget can be reshaped to achieve high priority objectives in a fiscally responsible way.
The U.S. Navy faces uncertainty about the degree to which it will have to prepare for a high-end future conflict versus the so-called Long War. To help the Navy understand how critical near-, mid-, and far-term trends in the United States, China, and Iran might influence U.S. security decisions in general and the Navy's investments in particular, RAND examined emerging domestic and regional nonmilitary trends in each of the three countries.
Resource added for the Psychology (includes Sociology) 108091 courses.
In this immensely timely book, Andrew Yarrow brings the sometimes eye-glazing discussion of national debt down to earth, explaining in accessible terms why federal debt is rising (and will soon rise much faster), what effects it may have on Americans if debt is not brought under control, why our government borrows, and what it will take to pay it all back. The picture Yarrow paints should concern all Americans. Specifically, he brings to light how rising Medicare, Social Security, and other spending on one hand, and insufficient government revenues on the other, make a mockery of fiscal responsibility. Deficits and debt, Yarrow asserts, are crowding out spending on needed investments in science, environment, infrastructure, and other domestic discretionary programs and could severely harm our nations and our citizens future. But he makes clear that this does not have to be a doomsday scenario. If we act in a bipartisan fashion to restore fiscal health, our legacy to the next generation can be much more than trillions of dollars of IOUs.
The American dream is fading: for nearly two decades, the economy has been performing below par, the quality of life has deteriorated, and the government has not confronted the public problems that concern citizens most. In this provocative book, Alice Rivlin offers a straightforward, nontechnical look at the issues threatening the American dream and proposes a solution: restructure responsibilities between the federal and state government. Under her plan, the federal government would eliminate most of its programs in education, housing, highways, social services, economic development, and job training, enabling it to move the federal budget from deficit toward surplus. States would pick up these responsibilities, carrying out a "productivity agenda" to revitalize the American economy. Common shared taxes would give the state adequate revenues to carry out their tasks and would reduce intrastate competition and disparities. The federal government would be freer to deal with increasingly complex international issues and would retain responsibility for programs requiring national uniformity. A primary federal job would be the reform of health care financing to ensure control of costs and to mandate basic insurance coverage for everyone. Published in the summer of 1992, Reviving the American Dream was read by presidential candidate Bill Clinton; by year's end, President Clinton appointed its author, Alice Rivlin, as deputy budget director. Today, the ideal in Rivlin's book—and Rivlin herself—are having an impact inside the administration. Selected as one of Choice magazine's Outstanding Books of 1993
Medicaid, one of the largest federal programs in the United States, gives grants to states to provide health insurance for over 60 million low-income Americans. As private health insurance benefits have relentlessly eroded, the program has played an increasingly important role. Yet Medicaid’s prominence in the health care arena has come as a surprise. Many astute observers of the Medicaid debate have long claimed that “a program for the poor is a poor program” prone to erosion because it serves a stigmatized, politically weak clientele. Means-tested programs for the poor are often politically unpopular, and there is pressure from fiscally conservative lawmakers to scale back the $350-billion-per-year program even as more and more Americans have come to rely on it. For their part, health reformers had long assumed that Medicaid would fade away as the country moved toward universal health insurance. Instead, Medicaid has proved remarkably durable, expanding and becoming a major pillar of America’s health insurance system. In Medicaid Politics, political scientist Frank J. Thompson examines the program’s profound evolution during the presidential administrations of Bill Clinton, George W. Bush, and Barack Obama and its pivotal role in the epic health reform law of 2010. This clear and accessible book details the specific forces embedded in American federalism that contributed so much to Medicaid’s growth and durability during this period. It also looks to the future outlining the political dynamics that could yield major program retrenchment.
Organized thematically around important questions in comparative politics, Introducing Comparative Politics, Fourth Edition by Stephen Orvis and Carol Ann Drogus integrates a set of extended case studies of 11 core countries into the narrative. Serving as touchstones, the cases are set in chapters where they make the most sense topically—not separated from theory or in a separate volume—and vividly illustrate issues in cross-national context. The book’s organization allows instructors flexibility and gives students a more accurate sense of comparative study. In this edition, a brand new chapter on Contentious Politics covers ethnic fragmentation, social movements, civil war, revolutions, and political violence. New case studies on this topic include the Occupy and Tea Party movements in the US; Zapatista rebellion in Mexico; Boko Haram in Nigeria; and; and revolutions in China and Iran. The chapter on States and Identity has been substantially revised to better introduce students to the concept of identity and how countries handle identity-based demands. Case studies include nationalism in Germany; ethnicity in Nigeria; religion in India; race in the US; gender in Iran; and sexual orientation in Brazil. Content on states and markets, political economy, globalization, and development has all been consolidated into a new Part III of the book, focusing in a sustained way on economic issues.
Governments throughout the industrialized world make decisions that fundamentally affect the quality and accessibility of medical care. In the United States, despite the absence of universal health insurance, these decisions have great influence on the practice of medicine. In Medical Governance, David Weimer explores an alternative regulatory approach to medical care based on the delegation of decisions about the allocation of scarce medical resources to private nonprofit organizations. He investigates the specific development of rules for the U.S. organ transplant system and details the conversion of a voluntary network of transplant centers to one private rulemaker: the Organ Procurement and Transplantation Network (OPTN). As the case unfolds, Weimer demonstrates that the OPTN is more efficient, nimble, and better at making evidence-based decisions than a public agency; and the OPTN also protects accountability and the public interest more than private for-profit organizations. Weimer addresses similar governance arrangements as they could apply to other areas of medicine, including medical records and the control of Medicare expenditures, making this timely and useful case study a valuable resource for debates over restructuring the U.S. health care system.