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Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Few contemporary social problems in the U.S. affect more people daily than those within the American health care system. Social Movements and the Transformation of American Health Care is the first collection of essays to examine dynamics of change in health care institutions through the lens of contemporary theory and research on collective action. Gathering scholars from medicine, health policy, history, sociology, and political science, the book considers health-related social movements from four distinct levels, concentrating on movements seeking changes in the regulation, financing, and distribution of health resources; changes in institutions in public health, bio-ethics, and other fields; interactions between social movements and professions; and the cultural dominance of the medical model, and the difficulties for framing and legitimizing new issues in health care it poses. At a time when American health care is long overdue for major changes, this book takes an essential look at movements, policies, and institutions to identify the common constraints and opportunities for reform within the health care system.
In no other country has health care served as such a volatile flashpoint of ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues. Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change. He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990sùand of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt RomneyÆs reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continuesùa penetrating account of how health care became such treacherous terrain in American politics.
Social medicine, starting two centuries ago, has shown that social conditions affect health and illness more than biology does, and social change affects the outcomes of health and illness more than health services do. Understanding and exposing sickness-generating structures in society helps us change them. This first book providing a critical introduction to social medicine sheds light on an increasingly important field. The authors draw on examples worldwide to show how principles based on solidarity and mutual aid have enabled people to participate collaboratively to construct health-promoting social conditions. The book offers vital information and analysis to enhance our understanding regarding the promotion of health through social and individual means; the micro-politics of medical encounters; the social determination of illness; the influences of racism, class, gender, and ethnicity on health; health and empire; and health praxis, reform, and sociomedical activism. Illustrations are included throughout the book to convey these key themes and important issues, as well as on Routledge’s webpage for the book, under the Support Materials tab. The authors offer compelling ways to understand and to change the social dimensions of health and health care. Students, teachers, practitioners, activists, policy makers, and people concerned about health and health care will value this book, which goes beyond the usual approaches of texts in public health, medical sociology, health economics, and health policy.
Is management a profession? Should it be? Can it be? This major work of social and intellectual history reveals how such questions have driven business education and shaped American management and society for more than a century. The book is also a call for reform. Rakesh Khurana shows that university-based business schools were founded to train a professional class of managers in the mold of doctors and lawyers but have effectively retreated from that goal, leaving a gaping moral hole at the center of business education and perhaps in management itself. Khurana begins in the late nineteenth century, when members of an emerging managerial elite, seeking social status to match the wealth and power they had accrued, began working with major universities to establish graduate business education programs paralleling those for medicine and law. Constituting business as a profession, however, required codifying the knowledge relevant for practitioners and developing enforceable standards of conduct. Khurana, drawing on a rich set of archival material from business schools, foundations, and academic associations, traces how business educators confronted these challenges with varying strategies during the Progressive era and the Depression, the postwar boom years, and recent decades of freewheeling capitalism. Today, Khurana argues, business schools have largely capitulated in the battle for professionalism and have become merely purveyors of a product, the MBA, with students treated as consumers. Professional and moral ideals that once animated and inspired business schools have been conquered by a perspective that managers are merely agents of shareholders, beholden only to the cause of share profits. According to Khurana, we should not thus be surprised at the rise of corporate malfeasance. The time has come, he concludes, to rejuvenate intellectually and morally the training of our future business leaders.
When first published in 1985, Sympathy and Science was hailed as a groundbreaking study of women in medicine. It remains the most comprehensive history of American women physicians available. Tracing the participation of women in the medical profession from the colonial period to the present, Regina Morantz-Sanchez examines women's roles as nurses, midwives, and practitioners of folk medicine in early America; recounts their successful struggles in the nineteenth century to enter medical schools and found their own institutions and organizations; and follows female physicians into the twentieth century, exploring their efforts to sustain significant and rewarding professional lives without sacrificing the other privileges and opportunities of womanhood. In a new preface, the author surveys recent scholarship and comments on the changing world of women in medicine over the past two decades. Despite extraordinary advances, she concludes, women physicians continue to grapple with many of the issues that troubled their predecessors.
In a work that spans the twentieth century, Nancy Tomes questions the popular--and largely unexamined--idea that in order to get good health care, people must learn to shop for it. Remaking the American Patient explores the consequences of the consumer economy and American medicine having come of age at exactly the same time. Tracing the robust development of advertising, marketing, and public relations within the medical profession and the vast realm we now think of as "health care," Tomes considers what it means to be a "good" patient. As she shows, this history of the coevolution of medicine and consumer culture tells us much about our current predicament over health care in the United States. Understanding where the shopping model came from, why it was so long resisted in medicine, and why it finally triumphed in the late twentieth century helps explain why, despite striking changes that seem to empower patients, so many Americans remain unhappy and confused about their status as patients today.
This book provides an in-depth evaluation of the U.S. health care system's development in the twentieth century. It shows how a unique economic design - the insurance company model - came to dominate health care, bringing with it high costs; corporate medicine; and fragmented, poorly distributed care.
An investigation into the foundations of democratic societies and the ongoing struggle over the power of concentrated wealth Much of our politics today, Paul Starr writes, is a struggle over entrenchment—efforts to bring about change in ways that opponents will find difficult to undo. That is why the stakes of contemporary politics are so high. In this wide-ranging book, Starr examines how changes at the foundations of society become hard to reverse—yet sometimes are overturned. Overcoming aristocratic power was the formative problem for eighteenth-century revolutions. Overcoming slavery was the central problem for early American democracy. Controlling the power of concentrated wealth has been an ongoing struggle in the world’s capitalist democracies. The battles continue today in the troubled democracies of our time, with the rise of both oligarchy and populist nationalism and the danger that illiberal forces will entrench themselves in power. Entrenchment raises fundamental questions about the origins of our institutions and urgent questions about the future.