Meyer J A, Lewin M E
Inquiry. 1986 Summer;23(2):122-33.
Actions to reduce the federal deficit in recent years threaten to strand the economically and socially disadvantaged while maintaining generous subsidy programs for populations with little or no financial need. This situation has been brought about in large part because of government's inherent reluctance to scale down programs that are politically popular even if no longer affordable or, in the long run, appropriate. The authors suggest that realistic and responsible social welfare policy reform requires that no sector of the federal budget be exempt from review or change. In the area of health, the importance of reshaping programs such as Medicare and Medicaid and disaggregating trends to focus more on populations with legitimate unmet needs is underscored. The authors make a number of suggestions on how existing social welfare programs can be better targeted.
近年来为减少联邦赤字而采取的行动，有可能使经济和社会弱势群体陷入困境，与此同时却仍在维持针对那些经济需求很少或毫无经济需求人群的慷慨补贴计划。造成这种局面的很大一部分原因在于，政府天生就不愿缩减那些政治上受欢迎的项目，即便这些项目已无力承担，或者从长远来看并不合适。作者们认为，切实可行且负责任的社会福利政策改革要求联邦预算的任何部门都不能免于审查或变革。在医疗领域，强调了重塑医疗保险和医疗补助等项目以及细化趋势以便更多地关注有合理未满足需求人群的重要性。作者们就如何更好地确定现有社会福利项目的目标受众提出了一些建议。
