Main description:

Ensuring America's Health explains why the US health care system offers world-class medical services to some patients but is also exceedingly costly, with fragmented care, poor distribution, and increasingly bureaucratized processes. Based on exhaustive historical research, this work traces how public and private power merged to favor a distinctive economic model that places insurance companies at the center of the system, where they both finance and oversee medical care. Although the insurance company model was created during the 1930s, it continues to drive health care cost and quality problems today. This wide-ranging work not only evaluates the overarching political and economic framework of the medical system but also provides rich narrative detail, examining the political dramas, corporate maneuverings, and forceful personalities that created American health care as we know it. This book breaks new ground in the fields of health care history, organizational studies, and American political economy.

Contents:

Introduction; 1. Background: physicians choose the insurance company model, late nineteenth century to 1940s; 2. Federal reform politics: implanting the insurance company model, 1945-60; 3. Sclerotic institution: the declining power of organized physicians and the AMA; 4. Organized for profit: the hidden influence of insurance companies and the HIAA; 5. The conflicted construction of Blue Shield: caught between Blue Cross and the AMA; 6. Corporate health care: from cost controls to medical decision making; 7. The politics of Medicare, 1957-65; 8. Epilogue: the limits of 'comprehensive' reform, 1965-2010.