The art of the deal: health policy making on the fly.

In September 1991 the Health Care Financing Administration touched off a two-month scramble by issuing regulations sharply curtailing states' use of voluntary donations and provider taxes to raise money for Medicaid. Days and nights of intrigue and dealmaking followed. Finally, on the day before Thanksgiving, Congress, the Administration, and the nation's governors agreed to a deal that may resolve the matter. During the course of those talks, all sides honed their negotiating skills and, in the process, uncovered basic flaws in the U.S. health care system.