Both federal and state governments consistently struggle to fund their portions of Medicaid allotments. The United States health care delivery system is exceedingly complex, and proposed solutions to remedy the identified problems may well have ramifications elsewhere in the economy. The 103rd Congress was unable to reach a consensus on the comprehensive changes needed. The 104th Congress is likely to consider separate and incremental actions. At the same time, the market place is reforming itself with the rapid onset of managed care, and states are implementing their own health care reform programs.
Direct access can greatly increase the availability and usage of preventive services.
Furthermore, substantial cost savings can be achieved by eliminating office visits and prior approval of appropriate, preventive laboratory services. Despite today's emphasis on primary care, citizens in rural and underserved areas frequently lack adequate access to health care services, often related to a local shortage of health care professionals. We believe reasonable and appropriate regulatory standards for laboratory operation and personnel are necessary in all sites to ensure reliable results. Health care reform legislative initiatives must include a mechanism for quality monitoring. When incentives exist to reduce expenditures, provisions must consistently be made to ensure quality is not compromised as a result.