Because of the dominance of the private sector in health care in the United States, health conditions are not as susceptible to changes in public policy as they are in other Western countries. however, the elderly and young children are directly affected by the federal government's health care policies and while both groups were the focus of major changes introduced by the Reagan administration, these changes were opposed buy Congress. Nevertheless, changes in health care funding and administrative arrangements have had a negative impact on the needy and, in addition, they have been exacerbated by the Reagan administration's wider social and economic policies which have contributed negatively to the health conditions of the poor.

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