The refederalization of American health care.

*Assistant Professor, Health Politics, Department of Public Health Policy and Administration, School of Public Health, University of Michigan, Ann Arbor, Mich. The endurance of a significant federal government role in health care into the late 1980s is remarkable, given the factors which seemed so likely to herald a new era of reduced central government involvement in health and countless other areas of domestic policy. Quite aside from the prospects for realignment and the overwhelming political success of a president with an abiding personal commitment to just such a &dquo;defederalization&dquo; strategy, spiraling health care costs and federal budget deficits seemed to augur not only a reduced role for the public sector in health care but, in particular, a reduced role for the central government. Health care was not a dominant issue in either the 1980 or 1984 election