Dead on Arrival
The Politics of Health Care in Twentieth-Century America
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- US$34.99
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- US$34.99
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Why, alone among industrial democracies, does the United States not have national health insurance? While many books have addressed this question, Dead on Arrival is the first to do so based on original archival research for the full sweep of the twentieth century. Drawing on a wide range of political, reform, business, and labor records, Colin Gordon traces a complex and interwoven story of political failure and private response. He examines, in turn, the emergence of private, work-based benefits; the uniquely American pursuit of "social insurance"; the influence of race and gender on the health care debate; and the ongoing confrontation between reformers and powerful economic and health interests.
Dead on Arrival stands alone in accounting for the failure of national or universal health policy from the early twentieth century to the present. As importantly, it also suggests how various interests (doctors, hospitals, patients, workers, employers, labor unions, medical reformers, and political parties) confronted the question of health care--as a private responsibility, as a job-based benefit, as a political obligation, and as a fundamental right.
Using health care as a window onto the logic of American politics and American social provision, Gordon both deepens and informs the contemporary debate. Fluidly written and deftly argued, Dead on Arrival is thus not only a compelling history of the health care quandary but a fascinating exploration of the country's political economy and political culture through "the American century," of the role of private interests and private benefits in the shaping of social policy, and, ultimately, of the ways the American welfare state empowers but also imprisons its citizens.
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The United States is alone among industrial democracies in having no national health insurance system, even as polls show large majorities of Americans favoring one. This comprehensive and convincing academic study illuminates this great American political conundrum. Gordon, a historian and author of New Deals: Business, Labor and Politics in America, 1920-35, examines reform efforts from the First World War to the Clinton health plan fiasco, and critiques scholarly explanations of the failure of more ambitious national healthcare initiatives. He explores America's idiosyncratic conception of healthcare as quasi-contractual social insurance and consumer commodity, not a right of citizenship, and its legacy in our ungainly system of private employment-based insurance. He traces the abandonment of national health insurance by its natural allies in the labor movement, which concentrated on protecting its private benefits, and among reformers, who settled for piecemeal programs that serve a portion of the population but undermine the rationale for universal coverage. Most of all, he points to the subservience of the American political system to economic interests. Time and again, he finds, the private healthcare industry has used its financial clout to"throttle" popular reforms through bare-knuckled lobbying, political donations, and PR campaigns associating national health insurance with Communism and vilifying successful Canadian and European systems. The result is a muddled system driven by the contradictory demands of doctors, hospitals, insurers and employers, one that generates the world's highest medical bills while leaving millions uninsured. Gordon synthesizes an enormous amount of scholarly research into a readable and compelling account of the debate over healthcare policy, one that poses larger questions about the failings of American democracy.
