ABSTRACT
Political economist Charles Lindblom achieved lasting professional fame half a century ago by describing American policy making as a process of "muddling through". More formally, political scientists call this type of policy making the doctrine of incrementalism: American policies change by small increments, not giant steps. This characterization is not always accurate, however. For now, government will continue to supplement the market by subsidizing care for those who lack the money to buy care privately, as well as for seniors of all incomes. Nonprofits and charities contribute substantially to the supply of medical services, often in clinics that are vital to the life of poverty-stricken communities. The Canadian health care system has been the lodestar for many American health care reform proponents. Once one gets over the big political hurdle that it replaces the private health insurance industry with a national health insurance system, it has much to recommend it.
