Gestor bibliográfico Crisis y Salud

The 2010 elections transformed U.S. politics. Emboldened by winning majority control of the House of Representatives and by the election of a new wave of fiscal conservatives, Republicans are resetting the national agenda. The recent agreement between congressional leaders and the Obama administration linking an increase in the government debt ceiling to significant cuts in federal spending underscores the change. The United States is entering a new age of austerity. The rise of austerity politics has important implications for health policy. The pervasive belief in Washington that deficit reduction is an economic imperative alters normal political rules. In a crisis environment, policymakers are more likely than usual to take on powerful interest groups and contemplate controversial reforms. The cycle of crisis and reform has long played out in the Medicare arena,1 where warnings of impending trust-fund bankruptcy have triggered important program changes, including the adoption of the prospective payment system for hospitals in 1983. Budget politics, in fact, drove federal health policy during much of the 1980s and 1990s. Policymakers sought to reduce federal deficits by restraining Medicare payments to medical providers, an effort that culminated in the 1997 Balanced Budget Act (BBA) that aimed to cut projected Medicare spending by 9%.2