State Governments and Their Capacity for Health Care Reform

In April 1994, during the conference on “Health Care Reform and the Role of the States,” in Chicago which ultimately lead to this volume, a debate raged among scholars of health care policy over the relative merits of state versus national leadership in health care reform. ¹ A common rendition of the question being asked at the time was “Can states take the lead in health care reform?” (Moon and Holahan 1992). ² A common response, in the literature and at the conference, was that health care reform was “simply too big a problem to be handled at the state level” (Stone 1992: 51). ³ The solution was for the federal government to comprehensively reform the nation’s health care system. ⁴