Setting Domestic Priorities: What Can Government Do?

This first-rate collection of essays addresses the fundamental question for American policy makers in the 1990s: how to confront a range of pressing problems in the face of daunting budgetary constraints. According to these authors, a decade of gridlock has left an overcrowded agenda. In chapter after chapter, focusing on topics such as health care, family policy, crime, and homelessness, the contributors suggest a substantial gap between current efforts and social needs. At the same time, the authors stress that the deficit itself represents a creeping crisis, and progress on the deficit must accompany efforts to reform individual policies.

The book is intended for a fairly broad audience. The individual essays seek to synthesize available research. Wherever possible, they forward views that have achieved some degree of consensus. As a result, the essays generally break little new ground, and specialists in particular areas of social policy are likely to be familiar with most of the arguments presented. However, the volume offers clear and accessible overviews of particular policy areas and issues. Because the assembled authors are leading figures in their fields, this alone represents a worthwhile contribution.

The volume is further strengthened by a coherent theme, which reflects the perspective that has become typical of publications from the Brookings Institution over the past decade. As they have in the past, Aaron, Schultze and their co-authors stress the importance of crafting tax and spending programs that carefully consider the repercussions for economic performance. Getting the best trade-off between equity and efficiency, they argue, is the key to allowing generous social provision. Long before it became fashionable in liberal circles, Aaron and Schultze were arguing that better government, rather than simply more government, should be the goal. Given the seriousness of current problems and the political barriers to increased taxation, social programs must be designed to squeeze the maximum results out of the limited resources available. The essays in this volume contain a range of thoughtful ideas for doing more in an era of limits. A remarkable number of proposals here are echoed in President Clinton's budget and health care initiatives. Indeed, if Clinton is successful he will have translated a large part of the Aaron/Schultze agenda into law.

Like many collections on domestic policy, the essays in the volume each consider a single issue. The adoption of this particular division of intellectual labor creates some serious problems. While generally informative, the narrow scope of these chapters prevents them from addressing the systematic shortcomings of American domestic policy-making. The essays on individual policies present a cumulative message of inefficiency and unmet need, but without contributing to n understanding of why this is the case or how policy making could be improved. By breaking down the analysis into discrete issue areas, much of this otherwise excellent volume may actually distract attention from the kinds of question that need to be answered if we are to understand why good ideas too rarely become good laws.

Paul Pierson
Associate Professor of Government, Harvard University