Vested interests are the main obstacles to reform, and the voice of the community is the main force for change
Implementation of health care reform is difficult because serious redesign of health care runs immediately into the power of vested interests. I personally witnessed this at the birth of Medicare in the 1970s, when I was Head of the Department of the Prime Minister and Cabinet. Government archives, both federal and state, are full of health reform proposals that have never been effectively implemented because of the power of these vested interests (see the article by Leeder and Lewis in this series1).
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