Remedy And Reaction: The Peculiar American Struggle Over Health Care Reform, Revised Edition Download Free (EPUB, PDF)
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 the Affordable Care Act 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.
Paperback: 360 pages
Publisher: Yale University Press; Revised edition (June 4, 2013)
Language: English
ISBN-10: 030018915X
ISBN-13: 978-0300189155
Product Dimensions: 1 x 6 x 9.5 inches
Shipping Weight: 15.2 ounces (View shipping rates and policies)
Average Customer Review: 4.3 out of 5 stars See all reviews (10 customer reviews)
Best Sellers Rank: #70,748 in Books (See Top 100 in Books) #22 in Books > Textbooks > Medicine & Health Sciences > Administration & Policy > Health Policy #52 in Books > Medical Books > Administration & Medicine Economics > Health Policy #54 in Books > Textbooks > Medicine & Health Sciences > Research > Epidemiology
This is a succinct and subtle exploration of the long-time debate over nationalized healthcare in the U.S. and about why "Hilarycare" lost and "Obamacare" was enacted. The fundamental problem, which Starr calls the "policy trap", is that important segments of society get enough out of a woefully inefficient system to resist, and to be suspicious of, any reform. The deductibility of health insurance premiums by employers and nationalized healthcare for the elderly via Medicare means that the most important voting blocs in society do well under the system without really appreciating the ridiculously high cost of what they are provided. Middle class people with jobs and senior citizens vote -- and they are invested in the status quo.Starr also probes into the darker side of American society -- the tolerance of suffering by others rationalized by the notion that I earned what I'm getting. Unlike any other advanced Western society, Americans question the right of citizens to get some minimum level of healthcare. And the polarization on this issue has gotten worse -- e.g., Starr cites polls showing that the percentage of Republicans who agreed with some such right has fallen from 37% to the low double digits.While Starr does not espouse an explicitly Marxian message, the implication of his argument is that the healthcare debate is simply class warfare by other means. The political branches protect, respond to, and even subsidize the economically powerful in society, while the dispossessed are frozen out, and then are blamed for their own predicament (in American mythology all can be obtained by effort and hard work, so if you can't provide healthcare to your family it's only because you're not applying yourself).
The United States has the most complicated and expensive healthcare system of any modern western industrialized nation. We also have the highest percentage of the population that goes uninsured. Why is this? In his book, Starr explained how we go to this point and why it has been so difficult to fix. The efforts to reform healthcare in this country is nothing new. There have been various efforts and reforms since the New Deal era and other than a few notable exceptions, such as Medicare, Medicaid and prescription drug benefits that target certain segments of the population we have failed to cover everyone. Starr argues that it is these very reforms that doomed the efforts to broaden medical coverage to even larger segments of the population. By covering certain constituencies such as the elderly, children and the very poor while leaving others uncovered the American people were divided into different groups with very different personal interests when it coms to health care. Those that are already covered want to maintain the status quo for fear that their benefits will be impacted while those that are not covered are to few and political powerless to influence policy while at the same time driving up care for the covered through emergency care. Add to this the various interests from doctors, hospitals, and drug manufacturers and the nature of our legislative process and you get a history of thwarted reform. In addition to giving the history of healthcare in the U.S., Starr does a very good job of explaining The Affordable Care Act (Obamacare) and putting it in the context of the previous 70+ years of attempts and failures to reform.
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