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You are here > Home > Reading Lists > Politics, Policy & Reform > Dead on Arrival: The Politics of Health Care in Twentieth-Century America

Dead on Arrival: The Politics of Health Care in Twentieth-Century America
Colin Gordon
 

Hardcover: 336 pages 
ISBN 0691058067
9780691058061
Princeton University Press
February 2003
Price: $52.50

 

Why, alone among industrial democracies, does the United States not have national health insurance?

Another autopsy of the failure to implement a US national health plan? Yes, but Dead on Arrival is more interesting, informative, and compelling than others. Its strength lies in the integration of multiple social, economic, and political perspectives within a historical context to address the question, why no 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.

"A treasure trove of information for anyone seriously wishing to tackle this issue." - Tom Gallagher San Francisco Bay Guardian

"Interesting, informative, and compelling... Addresses the question, why no national health insurance?" - Bernard S. Bloom Journal of the American Medical Association

Jacob S. Hacke Political Science Quarterly : Students of American public affairs will find much of value in Gordon's timely book.

"This is a bold, clearly written, and engaging analysis of the place of universal health insurance in the American welfare state. It represents a serious argument about the American political arena, presents a plausible argument for its position, and backs that up with a standard of scholarship I respect." - Ted Marmor, Yale University, author of The Politics of Medicare

"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... 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." - Publishers Weekly

This book provides these topics and resources:

  • Introduction: Why No National Health Insurance in the United States?
  • The Political Economy of American Health Care: An Overview, 1910-2000
  • Bargaining for Health: Private Health Insurance and Public Policy
  • Between Contract and Charity: Health Care and the Dilemmas of Social Insurance
  • Socialized Medicine and Other Afflictions: The Political Culture of the Health Debate
  • Health Care in Black and White: Race, Region, and Health Politics
  • Private Interests and Public Policy: Health Care's Corporate Compromise
  • Silenced Majority: American Politics and the Dilemmas of Health Reform
  • Conclusion: The Past and Future of Health Politics
  • Archival Sources

If you are interested in policy or books about health care reform, please see our up-to-date collection here: Politics, Policy & Reform.

(information from the publisher)

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