This volume describes partisan attempts to shrink the size of government by targeting two major federal health care entitlements, both by restructuring or eliminating entitlements as such and by privatizing and decentralizing programs. These efforts continue, along with more traditional attempts to amend and reform Medicare and Medicaid. Though they have radically transformed policy-making with respect to these programs, they have failed to achieve fundamental or lasting reform. Historical narrative and case studies are combined with descriptions of the technical aspects and dynamics of policy-making to help the reader understand how the process has changed, evaluate particular policies and outcomes, and anticipate future possibilities.