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One Nation, Uninsured: Why the U.S. Has No National Health Insurance

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Every industrial nation in the world guarantees its citizens access to essential health care services--every country, that is, except the United States. In fact, one in eight Americans--a shocking 43 million people--do not have any health care insurance at all. One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care nee Every industrial nation in the world guarantees its citizens access to essential health care services--every country, that is, except the United States. In fact, one in eight Americans--a shocking 43 million people--do not have any health care insurance at all. One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. Quadagno describes how at first physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized "grassroots" protests, conspiring with other like-minded groups to defeat reform efforts. As the success of Medicare and Medicaid in the mid-century led physicians and the AMA to start scaling back their attacks, the insurance industry began assuming a leading role against reform that continues to this day. One Nation, Uninsured offers a sweeping history of the battles over health care. It is an invaluable read for anyone who has a stake in the future of America's health care system.


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Every industrial nation in the world guarantees its citizens access to essential health care services--every country, that is, except the United States. In fact, one in eight Americans--a shocking 43 million people--do not have any health care insurance at all. One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care nee Every industrial nation in the world guarantees its citizens access to essential health care services--every country, that is, except the United States. In fact, one in eight Americans--a shocking 43 million people--do not have any health care insurance at all. One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. Quadagno describes how at first physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized "grassroots" protests, conspiring with other like-minded groups to defeat reform efforts. As the success of Medicare and Medicaid in the mid-century led physicians and the AMA to start scaling back their attacks, the insurance industry began assuming a leading role against reform that continues to this day. One Nation, Uninsured offers a sweeping history of the battles over health care. It is an invaluable read for anyone who has a stake in the future of America's health care system.

30 review for One Nation, Uninsured: Why the U.S. Has No National Health Insurance

  1. 4 out of 5

    Dylan Matthews

    This book is obviously a tad out of date, being written before the Affordable Care Act and ending with a list of recommendations that seem to foreshadow the ACA (Quadagno is very up on Medicaid expansion, and rightly so). But its strength is that it manages to weave the political history of specific battles — like Harry Truman's Fair Deal push for single-payer, or the passage of Medicare/Medicaid, or the failure of Clinton's plan — with the structural changes in the health business that shaped th This book is obviously a tad out of date, being written before the Affordable Care Act and ending with a list of recommendations that seem to foreshadow the ACA (Quadagno is very up on Medicaid expansion, and rightly so). But its strength is that it manages to weave the political history of specific battles — like Harry Truman's Fair Deal push for single-payer, or the passage of Medicare/Medicaid, or the failure of Clinton's plan — with the structural changes in the health business that shaped those fights. This especially helps in telling the story of Medicare Catastrophic coverage, a genuinely good bill that was immediately repealed upon senior backlash over additional fees, despite it being their last defense against corporations eager to cut health benefits for retirees. Quadagno makes a good case that the bill could thought of as a corporate bailout, a way to socialize the cost of the corporate welfare state that Walter Reuther and others built up in the 1950s and 60s as the bill came due. That works because of her lead-up explaining the revolt of businesses against health providers around the same time, as they concluded that the broad professional leeway they had given doctors and hospitals was no longer fiscally viable. That in turn enables a useful discussion of how insurers, rather than doctors, were the main antagonists for Clinton in 1994, a sharp contrast from the AMA-driven fights over Medicare and the Fair Deal. More broadly it's an important book to read if you want to understand why so many institutional actors in the Democratic party are still trying hard to develop an alternative to single payer that might try to mitigate the coalitional opposition that has doomed health reform repeatedly in the past. The big lesson of Quadagno is that you can't really overrun that opposition without well-organized allies that are even stronger, like unions and the AARP, which together got Medicare through, and even then after tremendous compromises. With unions basically dead and the AARP not a major player outside care for seniors, the prospects for a similar pro-reform coalition getting together now seem dim.

  2. 4 out of 5

    Debbie's Book Vlog

    Provides a good condensed history of our country's health care and why we have private insurance vs. national health care. Many Presidents in the 20th century have tried to pass some type of national health care. So many special interest groups have gotten in the way. From physicians to hospitals to insurance companies to labor unions. It appears more to be a matter of profits for these special interest groups to stop/block national health insurance vs the health of our population.

  3. 4 out of 5

    Bridget

    This was a thorough and clear history of the health care and health insurance industry in the United States. It was quite illuminating, especially that presidents and other lawmakers have advocated for national health insurance plans since the turn of the 20th century. I would recommend this book to anyone who is interested in health care reform, and what we can possibly do to fix our still broken and expensive system.

  4. 5 out of 5

    BDT

    Quadagno's history of US health care and health insurance is strong, yet tries to cover too much in a relatively short book. It also seems at times that Quadagno phrases and describes events in a way to favor a particular political agenda, but this is generally not too distracting.

  5. 4 out of 5

    Jeffrey Cavanaugh

    A history of US efforts to reform healthcare up to about 2004. Interesting and informative.

  6. 5 out of 5

    Donnie

    Tells us why we have had no luck in passing a National Health Insurance plan. Our biggest opponent throughout history has been the AMA--the American Medical Association. Jerks.

  7. 4 out of 5

    wall li

  8. 4 out of 5

    Joy

  9. 4 out of 5

    Angelica

  10. 5 out of 5

    Sonny

  11. 4 out of 5

    Pavel

  12. 4 out of 5

    Catherine

  13. 5 out of 5

    Edward ott

  14. 4 out of 5

    Erik Hadland

  15. 5 out of 5

    Jen

  16. 5 out of 5

    GoAskPerl

  17. 5 out of 5

    Drecon

  18. 5 out of 5

    Keely Jorgensen

  19. 4 out of 5

    Leo

  20. 4 out of 5

    Catherine Garcia

  21. 5 out of 5

    Michael Stevens

  22. 5 out of 5

    Ali

  23. 5 out of 5

    Albert

  24. 5 out of 5

    Megan

  25. 4 out of 5

    Susan

  26. 5 out of 5

    Karen!

  27. 4 out of 5

    Steve

  28. 4 out of 5

    Gianni Franco

  29. 4 out of 5

    Sarah Henke

  30. 4 out of 5

    Astrea Ward

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