ed as medical politics. A variety of special interest groups in the medical community exert a tremendous amount of influence on legislators. The most powerful of these interest groups lobby in favor of physicians, hospitals, insurance companies, and the drug industry.
Throughout history, the federal government has sought to limit its involvement in health care. The only times the government becomes aggressively involved is in circumstances related to crisis intervention and significant risks to the public health. As a result of the federal government's reluctance to enter the health care arena, health policy in the United States is essentially fragmented, with little evidence of coordination. This situation is unlikely to change, given the complex array of local, regional, and special interest considerations involved in formulating health policy: "Reform of the health care system in the United States is likely to be incremental, a compromise involving the resolution of a number of interests."
During the 1990s, health care reform became
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