Monday, September 7, 2009

The book on health care reform

We are not alone. This epic struggle about health care reform has been going on for a long time. Seventy-five years -- that's how long. Here’s a book written in fairly plain English that puts the fight into perspective. This review is from the Sunday NY Times Book Review section.

Currently, non-fiction.


By ROBERT B. REICH

Published: September 1, 2009


This timely and insightful book puts Barack Obama’s current quest for universal health insurance in historical context and gives new meaning to the audacity of hope. Universal health care has bedeviled, eluded or defeated every president for the last 75 years. Franklin Roosevelt left it out of Social Security because he was afraid it would be too complicated and attract fierce resistance. Harry Truman fought like hell for it but ultimately lost. Dwight Eisenhower reshaped the public debate over it. John Kennedy was passionate about it. Lyndon Johnson scored the first and last major victory on the road toward achieving it. Richard Nixon devised the essential elements of all future designs for it. Jimmy Carter tried in vain to re-engineer it. The first George Bush toyed with it. Bill Clinton lost it and then never mentioned it again. George W. expanded it significantly, but only for retirees.

David Blumenthal, a professor at Harvard Medical School and an adviser to Barack Obama, and James A. Morone, a professor of political science at Brown University, skillfully show how the ideal of universal care has revolved around two poles. In the 1930s, liberals imagined a universal right to health care tied to compulsory insurance, like Social Security. Johnson based Medicare on this idea, and it survives today as the “single-payer model” of universal health care, or “Medicare for all.”

The alternative proposal, starting with Eisenhower, was to create a market for health care based on private insurers and employers; he locked in the tax break for employee health benefits. Nixon came up with notions of prepaid, competing H.M.O.’s and urged a requirement that employers cover their employees. Everything since has been a variation on one or both of these competing visions. The plan now emerging from the White House and the Democratic Congress combines an aspect of the first (the public health care option) with several of the second (competing plans and an employer requirement to “pay or play”).

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4 comments:

Ken said...

I can only hope that Obama's audacity of hope has enough political oomph behind it to finally get it done this time, and with a government plan included.

Blog of Ages said...

The President's supporters seem to have been struck dumb and dumber by the town hall shouting brigade. And the Democrats are melting from a very vocal minority's heat. Difficult to watch. Even more difficult to understand how the Dems can control the House, Senate and White House -- and still lose the fight.

Ken said...

Good points, George. As some GOP lawmaker said a while back, if they can kill the healthcare reform they can cripple the president, and that's a goal big enough for the Republicans to pour all their energies into accomplishing. Same old, same old, on the part of the GOP (and too often the Dems as well): everything's done for political gain and little or nothing's done for the good of the country.

If the Democrats can't win this fight then what does it portend for the 2010 elections? That's what the GOP is hoping for: defeat this and win big in 2010.

Anonymous said...

The far right wing of the Republican Party is determined to bring down the Obama presidency at any and all costs. If he fails they can get back in control of all things political.

I'm not sure if they understand the social implications of their plan. Maybe they are simply paving an Autobahn to Armageddon.

The Democrats are so weak-kneed they can't stand up for anything. Always on the defensive, they are easily shouted down by mobs shouting innaine slogans.

If a health care plan doesn't cover the poorest of the poor it ain't worth diddly squat. I'm afraid we will end up with some compromise that leaves the insurance companies standing between the patient and the doctor. Then they will put lipstick on the dang thing and call it progress. --Ira

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