The Healthcare Debate

The Healthcare Debate

The Healthcare Debate

The Healthcare Debate

Synopsis

A dramatic reform of the nation's healthcare system has been on every American presidential administration's agenda since Teddy Roosevelt. And while much of the focus on the lack of progress concerns politics and big business, the fact is, Americans themselves remain ambivalent about government involvement in public health, healthcare financing, and healthcare delivery-despite the very real fact of existing deep and wide government involvement in American health care, from Medicare and Medicaid to vaccination programs, new pharmaceuticals screening, and the regulation of potent drugs and potentially harmful substances.

Excerpt

Writing a book about the debates surrounding healthcare policy reminds one, over and over again, of just how little the arguments actually have to do with health. Instead, the disputes about how to provide quality coverage to a greater portion of the population at affordable prices have strongly tended to focus on professional autonomy for health providers, notions of appropriate roles for government, and money, though not necessarily in that order.

This book traces the long-running debate over health care in an effort to help those who know a little about it to learn more, and to help those who know more to put their perspectives in a historical context. The chapters that follow describe both the changes and the continuities in the expert and general public discourses about how the medical profession has struggled to define itself, how government actors have at times supported and at other moments opposed a greater public-sector role in healthcare financing, and how interest groups and the public have contested matters of medical cost, quality, and access since the early 1800s.

One of the challenges of writing a short book on health care is the matter of scope. The themes range far and wide over a rapidly evolving landscape of public health issues; changing roles for government in financing and monitoring health outcomes; the rise of a massive insurance industry; labor market practices, including many recent developments in employer-employee relations in an age of nearly untenable retirement health benefit plans; technology-driven medical inflation; the changing character of the American Medical Association (AMA)—and the list goes on. In an effort to make this . . .

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