Focus: Washington – Coincidental politicsBMJ 1997; 314 doi: https://doi.org/10.1136/bmj.314.7096.1709l (Published 14 June 1997) Cite this as: BMJ 1997;314:1709
- John Roberts
President Clinton and the Republican Congress are still publicly congratulating themselves on reaching agreement earlier this year to balance the US government budget by 2002. But behind closed doors tempers are already shortening as the work begins.
There is no more fractious a spending topic than Medicare, the government programme to insure the elderly, which is also America's single biggest health insurance plan. The budget agreement calls for the programme, which has grown almost 200% over the past 10 years, to be cut by 8.5% over the next five. That means cuts of $115bn (£70bn).
The economics are simple. Everyone employed in the health sector will lose some, and some will …