For more than a decade students of health policy have predicted a revolution waged by corporate purchasers of health care who would rise in demand of public policy cures for increasing and burdensome health care costs. This forecast has been largely disappointed, however, as the business sector has remained oddly diffident in its demands for health policy reform. There are three reasons for business's reticence—the economic stakes of the corporate sector in health reform are uncertain, organizational encumbrances hamper business activism in this arena, and ideological convictions make business wary of governmental solutions. Although business is sometimes said to manipulate the policy process for its own material ends, in the health sphere the most likely road to reform may reverse this image: a newly activist federal government may have to mobilize business support for reforms that advance both corporate interests and larger social goals.

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