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 1990s—and of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt Romney’s 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 continues—a penetrating account of how health care became such treacherous terrain in American politics.
In this remarkable history, Yale sociologist and Pulitzer Prize winner Starr (The Social Transformation of American Medicine) says that America's contradictions (the opposing values of egalitarianism and self-reliance) are nowhere more evident than in the rancorous history of health care reform. Unlike citizens in other rich capitalist countries, Americans equate public responsibility for health care with a loss of freedom, while health care reformers and critics alike play on our distrust of Big Insurance and Big Government. There couldn't be a more astute insider to the politics of reform than Starr; some of his most riveting elements draw on his experience working on the Clinton administration's health care push, as well as his sharp critique of Obama administration reforms: "Obama would go from a position that was good politics but bad policy during the election to a position that was good policy but bad politics when he was president...." Starr's history of America's battle over whether health care should be a right is an exacting look at politics and policies and a challenge to Americans to overcome their fear and distrust in order to protect the sick and vulnerable.