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The Aura of Inevitability Intensifies

George D. Lundberg, MD

JAMA. 1992;267(18):2521-2524.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Major political change in a democratic republic such as ours comes about when a cluster of forces temporally coalesces to form a critical political mass of sufficient strength to power that change. Sometimes, tangential, seemingly unrelated events create that coalescence although the need for such change, people wanting it, and the resources necessary to produce it were long present. So it is with national health care reform in this country.

See also pp 2503 and 2509.

In my opinion, five salient events have brought health care reform to the forefront of the US national agenda:

1. 1. The nasty recession that began in 1990 and has lingered into 1992, causing large numbers of politically active voters without adequate health insurance to join the politically impotent poor in insisting on reform.
   
2. 2. The expanding tragedy of the AIDS epidemic, which created a large new group of highly educated and financially secure individuals
   

Footnotes
Reprint requests to Scientific Publications Group, American Medical Association, 515 N State St, Chicago, IL 60610 (Dr Lundberg).

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