In 1993, Massachusetts enacted an education reform that included an inflation-adjusted mechanism — the so-called "foundation buget" — designed to establish and preserve equity among districts and allow schools to operate at program levels envisioned at the time. In the past decade, however, rising costs have far exceeded inflation, a report from the Massachusetts Business Alliance for Education and the Boston Foundation argues. The report, School Funding Reality: A Bargain Not Kept, analyzed the formula that establishes the benchmark for adequate funding in each district, taking into account the special needs of disadvantaged youth, and determined the amount of state aid needed where local funds fall short. According to the report, the formula's inflation adjustment was adequate between 1993 and 2000, but the rise in healthcare costs has far outpaced the growth in state aid since then. As a result, per-pupil spending on teacher salaries, budgets for education materials, and funding in the neediest districts have fallen. The report concludes that it is imperative that the state control healthcare costs and cut expenditures outside the classroom.