Customer Reviews

The Heart of Power: Health and Politics in the Oval Office

5 star:		(7)
4 star:		(2)
3 star:		(0)
2 star:		(1)
1 star:		(0)

 

 

As a health policy researcher and doctor, I approach this book with some trepidation. I did not want a book that was going to feel like "work" to read, and yet I am genuinely interested in the details. Blumenthal and Marone got it just right. They move through a mountain of material in a well paced mix of interesting (often original) detail and insight. It could not be more timely given the debate in the country right now. This is the best available lense through which to watch how the national health reform process is playing out. Disclosure: Blumenthal used to be my boss.

At nearly 500 pages in length, this well-researched book may contain more historical information about the politics of health care than many people would care to read carefully.

After a 20-page introduction, the authors survey eleven successive presidents in eleven chapters:

(1) Franklin D. Roosevelt
(2) Harry S. Truman
(3) Dwight D. Eisenhower
(4) John F. Kennedy
(5) Lyndon B. Johnson
(6) Richard M. Nixon
(7) Jimmy Carter
(8) Ronald Reagan
(9) George H. W. Bush
(10) Bill Clinton
(11) George W. Bush

But the 12-page conclusion is worth the price of the book. In the conclusion, the authors set forth what they consider to be "eight rules for the heart of power" -- rules that President Barack Obama and others in his administration might want to consider carefully as the August recess of Congress draws to a close and the battle in Congress over health-care-reform legislation resumes in earnest.

Wonderful and insightful review of the approach to national health insurance since the 1930's by different presidents, from Franklin D. Roosevelt through G.Bush. In the process, we are made to understand what makes each man tick,his flaws and strengths.
We are also left to wonder some big what if's of national health policy as well as of possible second terms(particularly Lyndon Johnson's). As the authors mention in the introduction, our current president would be well served if he used this book as a road map for promoting his plan. Essential text to understand our current quandary.

David Blumenthal's and Jame's Morone's extremely readable history of healthcare reform from FDR forward is a must-read even if only for the wonderful stories told that were drawn from an immense amount of research into Presidential archives. Beyond that, it provides a well-constructed analysis of the reasons why health care reform is such a difficult nut to crack and the skills needed for reform to go forward. While they stay away from specific policy recommendations, for very good reasons, it is clear that they support reform that will insure that good health is in reach for all and no individual is wasted.

This book as a great inside look not only at the evolution of healthcare policy in the US, but a fascinating look at how Presidents have exercised the power of their office.

This is an invaluable book for anyone interested in the making of health policy in the US government. Very well researched and written by two experts in the field. I recommend it most highly.

I've read many books that expanded my store of knowledge, but few that changed my perspective. The Heart of Power changed the way I view health care policy and the ongoing debate about it.

Although the book covers the policies of each presidential administration from Franklin Roosevelt to George W. Bush (Gerald Ford excepted), it lays a foundation for an historical understanding of why Barack Obama made the critical decision to endorse a plan based on a public-private partnership. Blumenthal and Morone show convincingly that while liberals promoted and sustained the *idea* of universal health care access, conservatives were, over time, able to redefine the terms of the debate. The authors also include an important humanizing twist: Each president's personal -- and often traumatic -- experience with the health care system.

After WW2, no Democrat (save Jimmy Carter, who ran under unique circumstances) successfully ran for president without a major commitment to health care reform. And yet, once in office, each found passing legislation to be a maddening affair complicated by an arcane process, other priorities, formidable lobbying (first the AMA and the insurance industry). Truman never tried, and Kennedy and Clinton failed. Lyndon Johnson succeeded in enacting Medicare, but it was a surprisingly near thing.

Among Republicans, the private insurance market grew under Eisenhower and Nixon encouraged the development of HMOs. Concerned about the inevitability of a liberal government program, Eisenhower developed and Nixon refined Republican thinking about universal health insurance as a public-private partnership. Ronald Reagan pursued a massive extension of Medicare, later repealed when it proved unpopular with seniors. Bush I cared little about health policy, but his administration came up with ideas that Obama eventually coopted. In 2003, Bush II retreated on plans to offer privatized Medicare, Part D (a prescription drug benefit) when -- as incredible as it seems just seven years later -- the Republican leadership balked.

I have two criticisms of the book. First, the copy editing is execrable -- I'd estimate an error in punctuation, spelling, or conjugation every 10-15 pages. For example, President Obama's name is "Barack," not "Barak," and Bob Dole is from "KS," not "KA."

The Heart of Power would have been even stronger had it consistently considered the state of American health care in the context of each presidency, especially once more Americans had health insurance than did not, which occurred during the Eisenhower Administration. Sometimes, it's a little difficult to figure out exactly what problem a president is attempting to address and why. For example, was Bush I's disinterest in health policy a matter of disinclination or philosophy, or did he believe that there was no problem?

Overall, though, this is one of the few books that, without reading it, the individual citizen has an incomplete picture of an issue. We need more books like The Heart of Power that cover the history of a policy from its inception through the tumult of changing times. Highly recommended.

The quality of this book was very good and it arrived within the promised time limit. Other suppliers seem to be able to deliver their books more quickly.

Easy-to-read, thorough account of health insurance legislation, from FDR to W. It provides much needed historical, leadership perspective to our current health care mess. A must if you're serious about national policy, & enjoy politics. I went through it in two nights. Very well written.

Interesting subject. I'm a big fan of the mentor of this author - Richard Neustadt. Neustadt's book on Presidential power is the best I've ever read from an insider's perspective.

Unfortunately, this book misspells President Obama's first name ("Barak"), and is inconsistent in its framing of which presidents are covered in the book (i.e. GWB was not a 20th Century POTUS). This makes me give the rest of the book less weight as to its accuracy than I would otherwise. I suspect rush to print was done to get this out while health care reform was still a hot button issue and before the topic was more or less moot.