Chronic Politics: Health Care Security from FDR to George W. Bush

by Philip J. Funigiello

Overview

Few domestic issues dominate today's headlines as much as the high cost of health care. Despite this media attention and a litany of election-year debates over health care funding, some 45 million Americans remain without adequate health insurance. Philip Funigiello chronicles the contentious political history behind this state of affairs, from the New Deal to the present.

Funigiello unlocks the puzzle of why the United States has never guaranteed its citizens health security comparable to that enjoyed by people of other first-world nations—and he tells what needs to happen for policy reform to take place. Examining specific episodes in the history of health care financing, he highlights the importance of key individuals in the legislative process, the political haggling involved in shaping a bill, the clash of personalities and agendas that determine its fate, and the extent to which American ideas about fairness are reflected in the result.

Beginning with the National Health Survey of the 1930s, Funigiello traces the long struggle to enact Medicare and explains how medical inflation adversely affected both public and private employment-based insurance systems. He then recounts how Medicare became a target in the Republicans' war on spending, assesses the ill-fated Clinton health plan, and brings everything up to date with the Bush administration's expansion of Medicare to include prescription drug coverage.

Throughout this history, Funigiello shows that both liberals and conservatives, Democrats and Republicans, share the blame for not providing every American with health security as a right of citizenship. He argues that ideological values such as rugged individualism and laissez-faire capitalism have continually overshadowed the spirit of pragmatism, cooperation, and community ethos that health security requires.

As the swelling ranks of the uninsured threaten to destabilize the entire health care system for those who can still afford it, this country is faced with growing health insecurity unless we learn to rise above political differences. Chronic Politics is an incisive look at how history has affected current policy and is required reading for all concerned with the politics of financing health care in America.

Product Details

ISBN-13:	9780700613991
Publisher:	University Press of Kansas
Publication date:	09/21/2005
Pages:	408
Product dimensions:	6.00(w) x 9.00(h) x (d)

Table of Contents

Acknowledgments

Abbreviations

Introduction

1. Beginnings: The Federal Government and Health Security

2. Hopes Deferred: Congress, War, and the End of the New Deal

3. Health, Security, and the Cold War, 1945-1951

4. The Politics of Incrementalism, 1951-1960

5. Medicare: A Congressional Quagmire

6. Crossing an Ideological Rubicon

7. No Permanent Solutions: Health Care in Crisis

8. Health Care Reform: The Politics of Neglect and Rediscovery

9. “Competition under a Cap”: The Clinton Task Force

10. Clinton, Congress, and the Great Health Care War

11. Unfinished Business

Notes

Bibliographical Essay

Index

Editorial Reviews

"A well-crafted, detailed chronological account. . . . The combination of a solid grounding in scholarly research and a compelling writing style make Funigiello’s book accessible and rewarding for academics, students, and interested members of the public."—The Historian

"A solid, exhaustively researched synthesis of primary sources and the massive literature on health-care reform in America. Anyone new to the subject would, by reading this book, learn about the events that make up the story, both major and minor, and become acquainted with the enormous array of characters who joined the elusive quest for national health insurance. . . . A very useful book that expands our understanding of the uniqueness and peculiarity of U.S. health care."—Business History Review

"Funigiello’s story of the controversy over Medicare is rich in archival material and brings many of the personalities of that period to life."—Heath Affairs

"Well researched in both primary and secondary sources, this book puts flesh and bones on what, to many, is an abstract topic."—Choice

"From substantial archival research, Funigiello writes dramatic accounts of some of the most important moments in the history of national health care security. . . . It is essential reading for legislators, policy analysts, and advocates interested in building momentum for national health security."—The New England Journal of Medicine

“An incisive political history of our most notorious and persistent public policy failure that moves seamlessly from the early days of the twentieth century to the health politics of our own time. . . . Will interest those who want to understand the past, as well as those who want to shape the future.”—Colin Gordon, author of Dead on Arrival: The Politics of Health Care in Twentieth-Century America

“A most valuable resource in understanding the historical struggle for a basic human right that the U.S. still denies to its citizens.”—Vicente Navarro, author of The Politics of Health Policy: The U.S. Reforms, 1980–1994 and editor-in-chief of The International Journal of Health Services.

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