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Intensive Care: How Congress Shapes Health Policy edited by Thomas E. Mann and Norman J. Ornstein (Washington: The Brookings Institution, 1995), 316 pp., $18.95 (paper), $38.95 (cloth)
No one who followed the unhappy career of national health care reform, from the acclaimed introduction of President Bill Clinton's health care reform plan in September 1993 to its legislative demise a year later, is likely to doubt that Congress "shapes" (or deforms) health policy profoundly. This is hardly news: In the American system of separated powers, the national legislature is invited to work its will on the president's agenda or to develop an agenda of its own. There are, however, surprisingly few sustained accounts of how politics in and around Congress influences health policy. Learned treatises on Congress stand alongside numerous case studies of health policy making, but the twain seldom meet.
Intensive Care, an edited volume jointly produced by the American Enterprise Institute and The Brookings Institution, makes a welcome contribution to filling this gap. After an introduction by coeditors Thomas Mann and Norman Ornstein, the book presents chapters on committees (C. Lawrence Evans), budgeting (Joseph White), information and its uses in Congress (Mark Peterson), and oversight (Mark Nadel). There follow two case studies by Julie Rovner-one on the rise and fall of "catastrophic" benefits in Medicare, the other on Clinton's health care reform plan-and an analytical discussion of Congress and the Clinton plan, by Allen Schick. All of these chapters are solid, well written, and replete with subtle and salient insights. The authors admirably resist the theoretician's temptation to treat health (or other)...