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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.
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
Skocpol (government and sociology, Harvard U.) explores the changing currents of domestic U.S. politics through the prism of the defeat of President Clinton's comprehensive health care plan. She argues that the defeat reflected the success of Reaganite conservative tactics which switched from direct attacks on social programs to a fiscal starvation in the name of lower taxes. Annotation copyrighted by Book News, Inc., Portland, OR
Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.
A New York Times Bestseller, with an updated explanation of the 2010 Health Reform Bill "Important and powerful . . . a rich tour of health care around the world." —Nicholas Kristof, The New York Times Bringing to bear his talent for explaining complex issues in a clear, engaging way, New York Times bestselling author T. R. Reid visits industrialized democracies around the world--France, Britain, Germany, Japan, and beyond--to provide a revelatory tour of successful, affordable universal health care systems. Now updated with new statistics and a plain-English explanation of the 2010 health care reform bill, The Healing of America is required reading for all those hoping to understand the state of health care in our country, and around the world. T. R. Reid's latest book, A Fine Mess: A Global Quest for a Simpler, Fairer, and More Efficient Tax System, is also available from Penguin Press.
Since the 1960s, America's policymaking system has transitioned from one in which leaders like Lyndon Johnson could simply disparage the concept of budget projections to one in which policymakers consciously manipulate cost estimates. Paradoxically, the very safeguards put in place to thwart economically unsound legislation now cause chaos by incentivizing the development of flawed, even blatantly unworkable, policies. As Robert Saldin shows in When Bad Policy Makes Good Politics, the pathologies of the new system are illustrated by the Community Living Assistance Services and Supports Act and its role in aiding passage of President Obama's landmark health reform law. CLASS was supposed to bring much needed relief of America's dysfunctional long-term care system, but critics argued that its flawed design rendered the program unviable. However, what appeared to be a naïve proposal was actually a carefully framed policy designed to fit the rules of the game, particularly the Congressional Budget Office's cost-projection process. Although CLASS was destined for a "death spiral" requiring massive government bailouts, the CBO estimated it would save tens of billions of dollars. These official "savings" made CLASS an appealing add-on to the Affordable Care Act. But when the Obama administration later announced that CLASS was impossible to implement, America's long-term care system was left in crisis. This skillful examination of CLASS and the machinations of Congress provides insight into how the contemporary policymaking process really functions.
Designated a Doody's Core Title! Winner of an AJN Book of the Year Award! Who Has a Right to Health Care? What Is the Government's Role in Providing Accessible Health Care? How Are Corporations, Insurance Companies, and Health Care Providers Affecting the Quality of Health Care? And, Most Importantly, Can We Reform the U.S. Health Care System? We often debate these issues in health care policy or public health courses, yet we do so without the proper knowledge of the underlying structure of the U.S. health care system--or a framework by which it can be judged. Many health care workers entering the system are ill-equipped to address the issues faced in direct health care practice, in part because they have no ability to evaluate it. In this innovative text, Gunnar Almgren provides all the tools necessary to understand and critique a health care policy in dire need of change. First, he describes the historical evolution of U.S. health care, explaining how the early roles of hospitals, doctors, and nurses still influence today's system. He explains the complex financial aspects of health care, including the concerns of all its major stakeholders. He looks at the government's role in regulating and funding health care, and how that role has expanded and contracted through various political administrations. An entire chapter describes the facilities and services available for the elderly--an issue that will continue to rise in importance as America ages. Finally, he examines the many causes of disparities in the U.S. health care system. In addition, Almgren offers a unique social justice analysis as a framework by which the current system--and proposed reforms--can be judged. By analyzing the health care system through various models of social justice, we can begin to understand and address the urgent issues of economic, racial, and geographic disparities that plague our current system. With its clear, thorough, and comprehensive coverage of U.S. health care, this unique text is accessible to all those in public health, nursing, social work, public policy, or public administration. No other book addresses the underlying issues of the U.S. health care system alongside a variety of social justice models that we can use to evaluate, and perhaps eventually, change it.
A guide to the Affordable Care Act, our new national health care law. An account of the process from the 2008 presidential campaign to the moment in 2010 when the bill was signed into law before anyone had a chance to digest the document. At a time when the nation is taking a second look at the ACA, "Inside National Health Reform" provides essential information for Americans to review the governmental processes and politics in enacting this legislation.
In recent years, bitter partisan disputes have erupted over Medicare reform. Democrats and Republicans have fiercely contested issues such as prescription drug coverage and how to finance Medicare to absorb the baby boomers. As Jonathan Oberlander demonstrates in The Political Life of Medicare, these developments herald the reopening of a historic debate over Medicare's fundamental purpose and structure. Revealing how Medicare politics and policies have developed since Medicare's enactment in 1965 and what the program's future holds, Oberlander's timely and accessible analysis will interest anyone concerned with American politics and public policy, health care politics, aging, and the welfare state.
During his winning presidential campaign, Barack Obama promised to counter rising economic inequality and revitalize America's middle-class through a series of wide-ranging reforms. His transformational agenda sought to ensure affordable healthcare; reform the nation's schools and make college more affordable; promote clean and renewable energy; reform labor laws and immigration; and redistribute the tax burden from the middle class to wealthier citizens. The Wall Street crisis and economic downturn that erupted as Obama took office also put U.S. financial regulation on the agenda. By the middle of President Obama's first term in office, he had succeeded in advancing major reforms by legislative and administrative means. But a sluggish economic recovery from the deep recession of 2009, accompanied by polarized politics and governmental deadlock in Washington, DC, have raised questions about how far Obama's promised transformations can go. Reaching for a New Deal analyzes both the ambitious domestic policy of Obama's first two years and the consequent political backlash—up to and including the 2010 midterm elections. Reaching for a New Deal opens by assessing how the Obama administration overcame intense partisan struggles to achieve legislative victories in three areas—health care reform, federal higher education loans and grants, and financial regulation. Lawrence Jacobs and Theda Skocpol examine the landmark health care bill, signed into law in spring 2010, which extended affordable health benefits to millions of uninsured Americans after nearly 100 years of failed legislative attempts to do so. Suzanne Mettler explains how Obama succeeded in reorienting higher education policy by shifting loan administration from lenders to the federal government and extending generous tax tuition credits. Reaching for a New Deal also examines the domains in which Obama has used administrative action to further reforms in schools and labor law. The book concludes with examinations of three areas—energy, immigration, and taxes—where Obama's efforts at legislative compromises made little headway. Reaching for a New Deal combines probing analyses of Obama's domestic policy achievements with a big picture look at his change-oriented presidency. The book uses struggles over policy changes as a window into the larger dynamics of American politics and situates the current political era in relation to earlier pivotal junctures in U.S. government and public policy. It offers invaluable lessons about unfolding political transformations in the United States.