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Dead on Arrival: The Politics of Health Care in Twentieth-Century America (Politics and Society in Twentieth-Century America) Paperback – December 5, 2004

ISBN-13: 978-0691119519 ISBN-10: 0691119511

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Product Details

  • Series: Politics and Society in Twentieth-Century America
  • Paperback: 336 pages
  • Publisher: Princeton University Press (December 5, 2004)
  • Language: English
  • ISBN-10: 0691119511
  • ISBN-13: 978-0691119519
  • Product Dimensions: 6.1 x 0.8 x 9.2 inches
  • Shipping Weight: 15.2 ounces
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (2 customer reviews)
  • Amazon Best Sellers Rank: #522,735 in Books (See Top 100 in Books)

Editorial Reviews

From Publishers Weekly

The United States is alone among industrial democracies in having no national health insurance system, even as polls show large majorities of Americans favoring one. This comprehensive and convincing academic study illuminates this great American political conundrum. Gordon, a historian and author of New Deals: Business, Labor and Politics in America, 1920-35, examines reform efforts from the First World War to the Clinton health plan fiasco, and critiques scholarly explanations of the failure of more ambitious national healthcare initiatives. He explores America's idiosyncratic conception of healthcare as quasi-contractual social insurance and consumer commodity, not a right of citizenship, and its legacy in our ungainly system of private employment-based insurance. He traces the abandonment of national health insurance by its natural allies in the labor movement, which concentrated on protecting its private benefits, and among reformers, who settled for piecemeal programs that serve a portion of the population but undermine the rationale for universal coverage. Most of all, he points to the subservience of the American political system to economic interests. Time and again, he finds, the private healthcare industry has used its financial clout to "throttle" popular reforms through bare-knuckled lobbying, political donations, and PR campaigns associating national health insurance with Communism and vilifying successful Canadian and European systems. The result is a muddled system driven by the contradictory demands of doctors, hospitals, insurers and employers, one that generates the world's highest medical bills while leaving millions uninsured. Gordon synthesizes an enormous amount of scholarly research into a readable and compelling account of the debate over healthcare policy, one that poses larger questions about the failings of American democracy.
Copyright 2003 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.


"This is a sophisticated, impassioned, and well-documented analysis of the failures of twentieth-century American health reform efforts."--David Rosner, Business History Review

"[A] brilliantly recounted, thoughtful, and persuasive argument, not for simple explanations, but for a complex, on-the-ground discussion of what it was in the United States that made universal health insurance 'dead on arrival.'. . . [This book] is impeccably and impressively researched, drawing extensively on governmental and private archives."--Rosemary A. Stevens, Bulletin of the History of Medicine

"Another autopsy of the failure to implement a US national health plan? Yes, but Dead on Arrival is more interesting, informative, and compelling than others. Its strength lies in the integration of multiple social, economic, and political perspectives within a historical context to address the question, why no national health insurance?"--Bernard S. Bloom, Journal of the American Medical Association

"A welcome addition to a large literature on the modern United States medical system. . . . [It] illuminates the political deadlock and the institutional rigidity of the American system and offers a cogent explanation for why reform has been so intractable in health care throughout the last hundred years."--Declan O'Reilly, Enterprise & Society

"A treasure trove of information for anyone seriously wishing to tackle this issue."--Tom Gallagher, San Francisco Bay Guardian

"At a time of renewed popular and scholarly debate over America's exceptional welfare state, students of American public affairs will find much of value in Gordon's timely book."--Jacob S. Hacker, Political Science Quarterly

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23 of 25 people found the following review helpful By on June 3, 2003
Format: Hardcover
American politicians like to pride themselves on their pragmatism: Colin Gordon provides the valuable tale of how "pragmatism" got the United States Health Care system into an ungodly mess. By 1990 the United States spent 13% of its GNP on health care, while no other OECD country spent more than 9%. And yet at any given time at least 15% of Americans lack proper health insurance, while much of the insured's coverage is spotty and sacrificed to insurer profits. The generous system of remuneration practically breeds health care inflation. As one public relations consultant warned medical conservatives in 1961, the United States was the only major country not to have some form of national health insurance. He pointed out that if such a system was the high cost, low quality mess the AMA claimed it was, why hadn't conservatives in the 59 countries that had adapted successfully convinced people to change their minds and adapt the American system? A good question, but the AMA, the insurers, the hospitals and major employers have been alarmingly successful at keeping common sense at bay. Why is this the case?
Colin Gordon notes contrasting explanations such as American ideological opposition to government assistance, the institutional weaknesses of governmental welfare structures, and the power of anti-welfare capital. He points out the weakness of the first argument: national health insurance has always been popular in opinion polls. And the American government has improved its bureaucratic capacity over the years. The real problem is that, thanks to the nature of American politics and past mistakes, the forces supporting national health insurance have been weakened and fragmented and have never been able to match the influence of the powerful health care lobbies.
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Format: Paperback
Dead on Arrival is a scholarly, objective, detailed and well documented history of why the U.S. has not had universal health insurance. Anyone seriously interested in this issue will want to read this book carefully. The importance of race, unions, the AMA, Southern politics and a number of other factors are clearly described. The racial issue is particularly important and very well discussed in a 37 page chapter "Health Care in Black and White". Gordon makes it very clear that universal health care programs were antithetical to widespread segregation and especially Southern politics. In a 45 page chapter, "Bargaining for Health", Gordon discusses unions complicated role in opposing universal programs. "Through the formative years of the private welfare state, the core CIO unions chose security over solidarity and increasingly viewed universal health programs as a threat to the experience rates, preferential tax treatment, and employer financing enjoyed by job-based group insurance. By any measure, labor bet on the wrong horse..." This is a unique and very valuable book. Other good books on related issues:

Abramson, John, Overdosed America: The Broken Promise of American Medicine, Harper Perennial, 2004

Angell, Marcia, The Truth About the Drug Companies: How They Deceive Us and What to Do About It, Random House, 2005

Brownlee, Shannon, Why Too Much Medicine Is Making Us Sicker and Poorer, Bloomsbury USA, 2008

Cohn, Jonathan, Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price, Harper Perennial; 1 Reprint edition, 2008

Cutler, David M.
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