Power, Politics, and Universal Health Care
Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman--inter-nationally recognized expert in health policy and adviser to five US presidents--and fellow health care specialist David Shactman explain not only theMore »
Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman--inter-nationally recognized expert in health policy and adviser to five US presidents--and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation's health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. Despite its importance in history, few people know that Richard Nixon marshaled the best attempt to enact universal health care; or that he arranged secret health policy meetings with aides to Ted Kennedy in the basement of a Washington, DC, church. Who knew that the American Medical Association (AMA) publicly questioned the surgeon general's report that tobacco was harmful in order to defeat the Medicare bill, or that three separate sex scandals obstructed the road to universal health care? The authors look at key moments in health care history: the Hill-Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years. This book is essential reading for every American who must navigate the US health care system.« Less
the inside story of a century-long balttle
Clinton chooses wrong : the colossal defeat of managed competition
The past foreshadows the present : early attempts with little success
The Hill-Burton program : how America's uninsured poor got a right to free hospital care
The three-layer cake : Lyndon Johnson, Wilbur Mills, and the epic battle to enact medicare
Oops! the brief life and death of medicare catastrophic
Ted Kennedy and the Republican Congress : HIPAA and SCHIP add two more pieces to the puzzle
The unlikely saga of the medicare prescription drug benefit
Controlling health costs : many attempts but few successes
The last 20 years : health care spending keeps growing
Obama develops his plan
Early players and done deals
Baucus, Grassley, and the gang of six
The summer of death panels
The speaker carries the day
The Senate and the Christmas Eve health bill
Success at last
How he did it : a political strategy learned from history
The future is cost control
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