ABSTRACT
This chapter considers several general observations about the context of health care reform politics and explains the capacity of the states as health care reformers. In April 1994, during the conference on “Health Care Reform and the Role of the States,” a debate raged among scholars of health care policy over the relative merits of state versus national leadership in health care reform. Yet another indictment of state leadership in health care reform is that state efforts delay a national solution. The case for supporting the states’ capacity to take up the task of health care reform is threefold: state policy can better accommodate state diversity than national policy; the states have political and administrative advantages over the national government; and the states have demonstrated their capacity for reform in the most definitive way. In 1908, while president of Princeton University, Woodrow Wilson argued in favor of a decentralized approach to national economic development.
