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Experiencing Politics: A Legislator's Stories of Government and Health Care (California/Milbank Series on Health and the Public) Paperback – November 4, 2000

ISBN-13: 978-0520224117 ISBN-10: 0520224116 Edition: 1st

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Product Details

  • Series: California/Milbank Books on Health and the Public (Book 2)
  • Paperback: 336 pages
  • Publisher: University of California Press; 1 edition (November 4, 2000)
  • Language: English
  • ISBN-10: 0520224116
  • ISBN-13: 978-0520224117
  • Product Dimensions: 9 x 6 x 0.9 inches
  • Shipping Weight: 1 pounds (View shipping rates and policies)
  • Average Customer Review: 4.7 out of 5 stars  See all reviews (6 customer reviews)
  • Amazon Best Sellers Rank: #692,772 in Books (See Top 100 in Books)

Editorial Reviews

From The New England Journal of Medicine

John McDonough's Experiencing Politics is a brilliant book. McDonough provides a fascinating account of the high stakes, the drama, and the excitement involved in making laws. This is an enlightening and entertaining book that offers an inside, real-life look at legislating. McDonough's book seamlessly blends academic political science with lively "case stories" drawn from his 13 years in the Massachusetts legislature. His book will interest not only academics but also citizens engaged in the political process, especially those concerned with health policy. McDonough holds a doctorate in public health from the University of Michigan, and he specialized in health policy during much of his legislative career. That special interest is reflected throughout the book.

Perhaps a disclaimer is in order. John McDonough is a good friend of mine, and I have often turned to him for advice on health policy issues. His counsel was always valuable. The qualities that make him a valued advisor -- a clear understanding of the links between politics and policy, an instinct for what is achievable, a shrewd grasp of strategy and tactics, a sound understanding of the substance of health policy, and a passionate commitment to improving society -- are very much in evidence in this book.

McDonough uses a number of concepts from academic political science to explain how policy evolves. He discusses the use of language in politics, both as a barrier and an aid to reaching agreement and as a tactical weapon that can determine the outcome of a conflict. He describes the ways in which the scope, site, and intensity of a political conflict can shape its outcome and the ways in which participants in a political conflict may try to manipulate these factors to achieve their own goals. He explains how the positions taken by elected officials are shaped not only by their need to represent their constituencies but also by a web of relationships that can be even more important in defining the resulting policies. He explains the factors that determine whether incremental or comprehensive reform is achievable.

McDonough is a lively writer. The detailed descriptions of the fights over policy in which he has been involved are well worth the price of the book. One of the most interesting and important events McDonough describes is the effort to enact a children's health insurance program funded by increases in the cigarette tax -- a policy prescription I was later able to follow successfully in Washington.

McDonough explains how a combination of the mobilization of citizens, changes in political discourse, focused policy research, and a proposal that brought together advocates for children and senior citizens, proponents of expanded health insurance coverage, and antismoking forces made it possible to enact an important policy initiative that has made a real difference in the lives of tens of thousands of Massachusetts children. The achievement was even more remarkable because it required the override of a gubernatorial veto and the defeat of a well-funded opposition effort by the tobacco companies.

Other cases are equally compelling. McDonough discusses policy issues ranging from rent control, to attempts to deal with an urban gang that was impeding neighborhood redevelopment, to the demise of hospital rate setting, to the death penalty. The book includes portraits of the compelling figures, ranging from a charismatic urban priest to the Speaker of the Massachusetts House, who made a difference in the outcome of these policy debates.

McDonough's book is more than a scholarly dissection of what happens and why. It is a call to action and a guidebook for every citizen who cares about public policy and wants to have an effect on people's lives. His compassion for all Americans -- a trait that has characterized McDonough throughout his career -- comes through clearly in this important book. As McDonough says in his introduction, "Politics is about `us,' about the needs of ordinary people and how they get translated effectively or poorly into policies.... My challenge and hope are to help readers become more familiar and comfortable with life in the arena so that you will want to join." Any reader with an interest in politics and policy will benefit from reading this remarkable book.

Edward M. Kennedy

Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an out of print or unavailable edition of this title.


"McDonough's book deserves a wide medical audience as we reflect on where to go from here."--"Journal of the American Medical Association

More About the Author

John E. McDonough, DrPH, MPA is a professor of public health practice at the Harvard School of Public Health and director of the new HSPH Center for Public Health Leadership. Most recently, he was the Joan H. Tisch Distinguished Fellow in Public Health at Hunter College in New York City. Between 2008 and 2010, he served as a Senior Advisor on National Health Reform to the U.S. Senate Committee on Health, Education, Labor and Pensions. Between 2003 and 2008, he served as Executive Director of Health Care For All, Massachusetts' leading consumer health advocacy organization. From 1998 through 2003, he was an Associate Professor at the Heller School at Brandeis University. From 1985 to 1997, he served as a member of the Massachusetts House of Representatives where he co-chaired the Joint Committee on Health Care.

His articles have appeared in the New England Journal of Medicine, Health Affairs and other journals. He has written three books, Experiencing Politics: A Legislator's Stories of Government and Health Care by the University of California Press and the Milbank Fund in 2000, and Interests, Ideas, and Deregulation: The Fate of Hospital Rate Setting by the University of Michigan Press in 1998. His new book, Inside National Health Reform, will be published in July 2011 by the University of California Press and the Milbank Fund.

He received a doctorate in public health from the School of Public Health at the University of Michigan in 1996 and a master's in public administration from the John F. Kennedy School of Government at Harvard in 1990.

Customer Reviews

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Most Helpful Customer Reviews

7 of 8 people found the following review helpful By Glenn Koocher on December 16, 2000
Format: Hardcover
Former Massachusetts state legislator John McDonough takes readers from the theory to reality of practical politics in a surprisingly unegotistical fashion. He uses various theories about why and why political actors do what they do as they go about their business to introduce his own experiences.
The obligatory academics (the book is a valuable text book as well as a good read) are clear and easy to get through. The political stories are particularly informative and of great interest to people who want to know some of the 15,000 ways and by-ways that bills can travel to become law.
Experiencing Politics is instructive and should be required reading for zealots who'd rather make a point than make a difference. Of particular interest to all the victims of Narcissistic Advocates Personality Disorder (the Nader types, the zealots, the self righteous as only the Boston/Cambridge axis can breed) are McDonough's experiences and observations as an advocate for housing and as one who tried to ameliorate the impact of the loss of rent control.
Massachusetts political junkies and students of legislative process should love this book. McDonough doesn't describe his role as that of savior or saint, but as an interested student and practitioner of practical progressive politics who wants to be a player in his legislature.
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Format: Paperback Verified Purchase
"Experiencing Politics" is a look at legislative politics as observed by a state legislator, John McDonough, who served in the Massachusetts legislature. It is interesting reading one legislator's account and descriptions of how the legislative process works. Political theory and reality are compared. For instance, the author notes that it was Machiavelli who noted that strong societies channel their political conflicts and social frictions into a democratic process. These democratic battles actually strengthen society. It is governments that suppress conflict that become unstable. He notes this appears to be true, as no democratic government has even gone to war against another democratic government.

The author observes that political mobilization is dominated by wealthier political interests. This is especially noticed in political fights over Massachusetts's health care system, which is a focus of this book. This fight is particular fierce for one wealthy side's gain would come at the expense of another wealthy side. This clash of political titans creates a major schism in attempting to make any changes to the current health care system.

While wealthier interests may have advantages, this does not mean that parties with lesser influence are forgotten. The author observes that while political leaders from both parties had favored landlords in revising landlord-tenant law, neither side wished to be publicly identified with landlords. Thus, the legislation was revised in a manner than favored tenants, even though tenants appeared to have less influence over the legislature.

The author urges parties in a political dispute to learn the real and personal interests of the parties involved in the dispute.
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4 of 6 people found the following review helpful By A Customer on December 6, 2000
Format: Paperback
John McDonough makes political theories come to life by blending them with war stories from time spent in the tumultous world of Massachusetts politics. The acount of how he changed from a often confused (and confusing) radical young state representative to an effective player on the side of good government provides useful guidance to anyone interested in using the political process to effect change or who would just like a better understanding of who gets what, why, and how.
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