policy provides a vivid illustration. For a dozen years Republican administrations developed and maintained highly restrictive policies on abortion rights: (i) in a 1984 order known as the "Mexico City Policy," President Reagan prohibited the United States from providing foreign aid to family planning programs that were involved in abortion-related activities; (ii) in memoranda in 1987 and 1988, the National Institutes of Health placed a moratorium on federal funding of research involving the implantation of fetal tissue from induced abortions; (iii) by memoranda of 1987-1988, the Department of Defense banned all abortions at U.S. military facilities, even where the procedure was privately funded; (iv) in a 1988 regulation known as the "gag rule," the Department of Health and Human Services prohibited family planning clinics funded under Title X of the Public Health Service Act from counseling or referring women for abortion; and (v) in two Import Alerts issued in 1988-1989, the Food and Drug Administration excluded Mifepristone (RU-486) from the list of drugs that individuals can import into the United States.

On the twentieth anniversary of Roe v. Wade, January 23, 1993, President Clinton signed five memoranda that repealed all five of these policies-reversing a dozen years of policy on reproductive rights and medical privacy. The result of these sharp changes in policy by the executive is that America never seems to attain a settled policy on the issue of reproductive rights. The strongly ideological positions of the executive branch often allows it to lose sight of the questions that are central to the development of sound health policy-will the policy be effective in protecting and promoting the health of the public and will it adequately safeguard human rights?

CONCLUSION

As this paper is being written, the President's Task Force on National Health Care Reform, chaired by the First Lady, has completed its work, and the President has sent a bill to Congress for systematic reform of the health care system.88 The President and the First Lady have compared this initiative of the executive to the Manhattan Project and the New Deal. The President was able to marshall the resources of several hundred experts within and outside of government to fundamentally reform the financing, organization, and delivery of health care in the United States.

This will provide a unique opportunity to observe the workings of two powerful branches of government on a health policy issue that can produce enormous social good for millions of Americans by enhancing their access to care, reducing inequalities, and allocating benefits and burdens more equitably. Will the President and Congress jointly develop a new health care system that is beneficial and just? Or will they become stalled in



The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement