Remedy and Reaction: The Peculiar American Struggle over Health Care Reform

By Cohen, Alan B. | Inquiry, Summer 2012 | Go to article overview

Remedy and Reaction: The Peculiar American Struggle over Health Care Reform


Cohen, Alan B., Inquiry


Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform. By Paul Starr. New Haven, Conn.: Yale University Press. 2011. 309 pp. $28.50.

Many readers familiar with Paul Starr's highly acclaimed book, The Social Transformation of American Medicine, published nearly three decades ago and recognized today as the definitive history of the medical profession's rise to prominence in the United States, have long wished for a sequel that would carry the story forward to the present day. Remedy and Reaction: The Peculiar American Struggle Over Health Care Reform is not that sequel, but it unquestionably is a worthy companion to Starr's earlier work.

This aptly titled book recounts the century-long struggle over health reform in the U.S., beginning with the Progressive era of 1915-1919 and concluding with the Patient Protection and Affordable Care Act (ACA) of 2010. Curiously, the inspiration for the book's title is not revealed until the final chapter when Starr credits Arthur Schlesinger, Jr., with having noted "that politics in a democracy (transcends) the struggle for power or the manipulation of image" and "is above all about the search for remedy." Starr hastens to add that the search for remedy to a social problem inevitably triggers reaction, especially in a deeply divided political environment. He calls the American struggle over health care "peculiar" because of the unusual lines on which it has been fought and because the problems are not restricted to the least powerful members of society. For example, he points out that special interests have not always been aligned only on one side of the debate, and that much of the bias against change often comes from "members of the protected public," such as Medicare beneficiaries. He also argues that many middle-class Americans, not just the poor, suffer the misfortune of becoming sick while being uninsured. Such peculiarities are unique to our system, and they continue to shape both our political debate and our current reform efforts.

The book is divided into three parts. In Part I, Starr traces health care reform from its origins as a search for universal health insurance in the Progressive era, followed by the failure to enact national health insurance (along with Social Security) during the Great Depression and New Deal years, to its evolution as a quest for comprehensive system reform in the 1970s and 1980s. He describes the "policy trap" that ensnared the U.S. following World War II, when American Medical Association opposition to national health insurance defeated President Truman's proposal even as Congress enacted legislation that led to unprecedented hospital construction and service expansion (exactly the reverse of Western democracies' establishment of universal insurance programs before embarking on campaigns of system infrastructure development). Once private employer-based insurance had become the dominant form of coverage for many Americans, Starr argues that the U.S. found itself with a "deeply dysfunctional system that the country could not readily bring itself to change." Although the creation of the Medicare and Medicaid programs in 1965 was a limited victory for social insurance, it also added to the complexity and fragmentation of the health care system, further hampering reform efforts. Starr highlights the dramatic shift in reform efforts from a focus on coverage to a focus on costs as health care spending grew at historic rates following the lifting of wage and price controls in 1974. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Remedy and Reaction: The Peculiar American Struggle over Health Care Reform
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.