Vanderbilt Law Review


Susan E. Powley

First Page



Health care reform is once again on the "front burner" of American politics. With health care costs in the United States rising at three times the rate of inflation and an increasing portion of the population falling through the cracks of the current health care delivery system,' legislators, health care professionals, and the population at large now have little difficulty agreeing that the system is badly in need of reform. This consensus, however, falls apart when discussion turns to what needs to be fixed and how to fix it. Federal legislators currently have over twenty health bills pending before them, and state governments, tired of waiting for a consistently elusive federal solution, have begun seeking their own solutions to health care problems.'

While perhaps the current focus on health care reform is unsurprising in light of election year politics, there is compelling evidence that Americans are rightly concerned about the state of health care in this country. The United States is now one of only two major industrialized nations that have yet to implement some form of universal health care system for their citizens. Despite possession of the most advanced medical technology and the most highly skilled medical personnel in the world, the United States consistently rates well below other countries in life expectancy, infant mortality, and low birth weight.' Rapidly rising costs and the growing number of uninsured and underinsured undoubtedly contribute to these gloomy statistics by limiting the access of many citizens to even basic health care.' Administrative inefficiency, waste, and health care fraud compound the problem by needlessly consuming limited health care funds, both private and public." It is little wonder that the cry for reform has become so universal and so persistent.