American Health Care
edited by Roger Feldman
Independent Institute - 2000 - 429 pages - $39.95
American Health Care is the work of 15 writers expert in different facets of the health-care delivery debate. I regard it as one of the best books on the problems in our health-care system since Paul Starr's 1982 prize winner, The Social Transformation of American Medicine.
The contributors have the advantage over Starr of the intervening years of experience gained from government-controlled and privately administered managed-care systems. We have learned much in the last 20 years about the waste and inefficiency generated by government attempts to manage and improve on the market for medicine and health care.
The failure of Hillary Clinton's Task Force and its proposals for a government takeover of most of our health-care system serves as a backdrop to the book. Editor Roger Feldman (professor of health insurance at the University of Minnesota) writes, "To discover why [Clinton's] health care reform failed, it's more enlightening to read the popular press than the academic journals. The press intuitively understood that the American People were not willing to entrust the government with running the health care system." At that point, I knew I was holding a book I had to read.
There are four main sections to the book. Part I addresses health insurance and finance. Ronald Hamowy's historical review of government-inspired health-care delivery efforts, starting with Bismarck's Germany in 1883, should be "must" reading for any student of health-care reform. Charlotte Twight's discussion of the 1996 Health Insurance Portability and Accountability Act made me aware that despite my efforts to stay abreast of the government's involvement in health care delivery, I failed to appreciate the scope of this legislation. It created a national medical information database and made it possible for the secretary of health and human services to rewrite rules concerning the privacy of individual medical records. "For the common good" will be a new force …