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Remedy and Reaction: The Peculiar American Struggle over Health Care Reform Hardcover – October 25, 2011

ISBN-13: 978-0300171099 ISBN-10: 0300171099 Edition: 1st

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Product Details

  • Hardcover: 336 pages
  • Publisher: Yale University Press; 1 edition (October 25, 2011)
  • Language: English
  • ISBN-10: 0300171099
  • ISBN-13: 978-0300171099
  • Product Dimensions: 9.5 x 6.5 x 1.1 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (11 customer reviews)
  • Amazon Best Sellers Rank: #532,488 in Books (See Top 100 in Books)

Editorial Reviews

Review

"[A] clear, comprehensive, and compelling chronicle of the health care debate....Starr is at the top of his game."—Glenn Altschuler, Huffington Post (Glenn C. Altschuler Huffington Post)

"[Starr's] unsentimental perspective serves him well in this outstanding volume."—Harold Pollack, Washington Monthly
(Harold Pollack Washington Monthly)

Winner of the 2011 American Publishers Awards and Scholarly Excellence (PROSE) in the Government and Politics category, as given by the Association of American Publishers
(PROSE Award in Government and Politics Association of American Publishers 2012-02-02)

"Remarkable. . . . There couldn't be a more astute insider to the politics of reform than Starr. . . . Starr's history of America's battle over whether health care should be a right is an exacting look at politics and policies—and a challenge to Americans to overcome their fear and distrust in order to protect the sick and vulnerable."—Publishers Weekly, Starred Review
(Publishers Weekly)

"First, [Starr] objectively draws together the threads of myriad voices and special interests in the centurylong American health-care debate and weaves them into a wholly comprehensible pattern. ...Second, Starr cogently explains the highlights of the recently passed and highly controversial Affordable Care Act...In sum, this self-admitted universal-health-care advocate and seasoned realist leaves readers questioning, as he does, whether Americans can 'summon the elementary decency toward the sick that characterizes other democracies.'" —Donna Chavez, Booklist (starred review)
(Donna Chavez Booklist)

“The best summary and political analysis of health care reform I’ve read....Starr nails every nuance while taking the analysis one level deeper than any other treatment I’ve read.”—Austin Frakt, The Incidental Economist (Austin Frakt The Incidental Economist)

“Paul Starr has written a fascinating chronicle of America’s century-long journey to health reform that is, at once, erudite history, vivid journalism, and authoritative guide to a debate that will continue for decades.”—Henry J. Aaron, co-author of Using Taxes to Reform Health Care
(Henry Aaron 2011-06-02)

"Three decades ago Paul Starr wrote the definitive history of American medicine.  Remedy and Reaction now offers the definitive analysis of American health care reform—its history, nature, and continuing vulnerability."—Timothy Jost, co-editor, Transforming American Medicine:  A Twenty Year Retrospective
 
(Timothy Jost 2011-06-06)

"Remedy and Reaction is the story of health care in America, told by the man who knows it best. Whether you're a serious scholar or just a serious citizen, you should read this."—Jonathan Cohn, senior editor, The New Republic
(Jonathan Cohn 2011-06-14)

"Here’s the book we’ve been waiting for—a lucid history of America’s struggle over healthcare reform, blending the political, economic, and social pressures that have brought us to where we are, and suggesting where we’re headed. With great insight and impeccable writing, Paul Starr explains why that struggle has been particularly bitter and partisan in the United States, why the resulting compromises have left so many people unsatisfied, and why the underlying problems continue to evade us. Brilliant and important."—Robert B. Reich, Chancellor's Professor of Public Policy, Goldman School of Public Policy, University of California, Berkeley
(Robert B. Reich 2011-06-17)

"Paul Starr, who gave us a magisterial account of the history of American medicine, now has given us the definitive account of the history of the struggle to enact health reform in America. Starr has done more than just study reform—he was a player in efforts to achieve it. Remedy and Reaction is in some ways thus an insider's history, which only enriches the experience of the reader. This book is a lively read, but has depth and insight. From its account of the early experiences in the twentieth century with reform, up through the disappointments in our livetimes to achieve any comprehensive change, through the enactment of the Affordable Care Act and the story of its uncertain future, Remedy and Reaction is the definitive account of the history of health reform in America." —Norman Ornstein, co-author of The Broken Branch: How Congress Is Failing America and How to Get it Back on Track
(Norman Ornstein 2011-06-27)

"Few books as important as this one is are as clearly and compellingly written.  Remedy and Reaction is a brilliant analysis of the political conflicts and compromises that led to the passage of the Affordable Care Act, and a fitting sequel to Paul Starr's masterful book, The Social Transformation of American Medicine. The final page came much too soon."—Shannon Brownlee, author of Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer
(Shannon Brownlee 2011-06-28)

"[D]elivers an insightful political analysis."—Kristen Greencher, The Charlotte Observer
(Kristen Greencher The Charlotte Observer)

"As a work of policy history Remedy and Reaction excels…. [Starr] chronicles just how difficult a struggle it has been to make the U.S. healthcare system more equitable and efficient and how far we still have to go."—Jonathan Oberlander, Science
(Science)

“ [A] remarkable chronicle of the hundred-year effort to legislate universal health insurance in the United States…. Nobody with a sense of history—that is, nobody who reads Starr’s book—could doubt how sensible and brave was the president’s effort to drive the Patient Protection and Affordable Care Act of 2010 through Congress.” —Bernard Avishai, The Nation
(Bernard Avishai The Nation)

"[An] interesting and engaging account of the many attempts made over the past century to reform care in this country. As daunting, even wonkish, as this may sound, Starr does an excellent job of explaining the different proposals and identifying the reasons why some succeeded where others failed so spectacularly."—Dennis Rosen, Boston Globe
(Dennis Rosen Boston Globe)

"[A] useful and lucid history of American health reform . . . Anyone seeking to understand how difficult it will be to implement President Barack Obama's health care reforms will be enlightened by Starr's readable and engrossing narrative. Highly recommended."—Jeff Goldsmith, Health Affairs
(Jeff Goldsmith Health Affairs)

"[C]oncise and beautifully written."—Michael Gusmano, Commonweal
(Michael Gusmano Commonweal)

"None of the numerous other histories of US health care policy develops these themes in such an illuminating fashion. . . . [an] excellent, cogently argued work."—Samuel Y. Sessions, Journal of the American Medical Association
(Samuel Y. Sessions Journal of the American Medical Association)

“Excellent, cogently argued.”—Journal of the American Medical Association

(Journal of the American Medical Association)

“Engrossing.”—HealthAffairs

(Health Affairs)

From the Author

What do you most want people to understand from reading this book?
 I hope the book illuminates how an issue that is more or less settled in every other democracy became a seemingly intractable political problem in the United States.
It did not have to turn out this way. The legislation adopted in 2010 has its roots in moderate Republican proposals. But America’s polarized politics make it difficult to see the reforms clearly and put them in historical perspective. I hope the book helps to provide that understanding.

What’s the relationship of Remedy and Reaction to your 1984 book, The Social Transformation of American Medicine?
 In some ways it’s a sequel, but each of its three parts has a somewhat different foundation.  Part One, about how health-care reform and the health-care system took shape during the twentieth century, presents the same kind of social and historical analysis as Social Transformation did.
But Part Two, which deals with the parallel stories of the Clinton health plan and Republican health reforms in the Gingrich and Bush years, also reflects my observations inside the Clinton White House. That’s a kind of experience not usually available to historians.
Finally, Part Three, about the battle over health-care reform under Obama, combines journalism and historical analysis because it draws on interviews with participants, many of whom I know from my prior time in Washington.

Why did Obama succeed where Clinton failed?
 Between 1993 and 2009, the biggest change was the emergence of a consensus about the basic elements of legislation among reformers, major interest groups, and leading Democrats in Congress. The reforms adopted in Massachusetts in 2006 as a result of Mitt Romney’s leadership were critical in shaping that consensus.  Obama accepted that approach; he didn’t originate it. Romney probably deserves more credit for the basic architecture of the national reforms, and I hope one day he proudly accepts that credit.

Didn’t Obama’s leadership matter?
If Obama hadn’t decided to make health-care reform a priority as president, it would never have passed.  Why did he take it on? His earlier history didn’t indicate a deep commitment to health-care reform. I think the 2008 presidential campaign was crucial because of the pressure from the party base to confront the issue, plus an accident of history: he ran into Hillary Clinton on the way to the nomination, and debating her forced him to master health policy. Perhaps most important, the support for reform from key stakeholder groups and members of Congress changed the political calculus on health care. That’s what made it a better bet than climate legislation.


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Customer Reviews

4.5 out of 5 stars
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A timely read.
Chalmers M Nunn, Jr
The book is to be valued especially for its account of the evolution of the Affordable Care Act.
Fred B. Smith
This is a fascinating book, and a relatively well written one.
Nathan B

Most Helpful Customer Reviews

25 of 26 people found the following review helpful By bjcefola on November 3, 2011
Format: Hardcover
This is an extraordinarily readable discussion of health care reform. The book is worth getting for the first chapter alone, which summarizes reform efforts from the progressive era through Carter with enough detail to articulate why programs like Medicare succeeded versus the many others that failed.

Starr then devotes chapter length treatments to the Clinton and Obama plans, describing how the Clinton plan got sandbagged and how Democrats in 2009 struggled to avoid the same fate.

Highly recommended!
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34 of 37 people found the following review helpful By Loyd E. Eskildson HALL OF FAME on October 23, 2011
Format: Hardcover
The U.S. spends far more on health care than others - 17.6% of GDP, compared to an average of about 9% in other economically advanced nations. Meanwhile, as of 2010, about 50 million Americans are without health insurance at any time, our outcomes are, at best, only comparable, and variation in disease rates do not explain the cost differences either. Higher prices, however, do. Paul Starr's 'Remedy and Reaction' provides excellent insight into how this has occurred. Briefly, during the first half of the 20th century the U.S. diverged from the more common path taken by western democracies and failed to establish a general system to finance health care. Instead, it ensnared itself in what Starr calls 'a policy trap,' devising an increasingly costly and complicated system that satisfied enough of the public (veterans - a separate system established after WWI; employer provided - encouraged by tax benefits and its offering a way around WWII wage/price controls; Medicare - 1965; Medicaid - 1965) and so enriched the industry as to make change very difficult now that it consumes nearly one-fifth the American economy. When the major European countries created their national insurance systems between the 1880s and early 1900s, health care was a small proportion of their economies, about 3%, and thus much more easily maneuvered.

Now, not only are providers and insurers likely to provide strong resistance to change, the public is as well. Some because they view their existing coverage as 'earned' and resent others receiving similar status, others see their freedom of choice being limited, while fear of benefit reductions and/or growth in government spending motivate still others.
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5 of 5 people found the following review helpful By Anne Mills on December 1, 2012
Format: Hardcover Verified Purchase
An excellent and very informative history of government efforts to reform health care in the U.S., leading up to a brilliant analysis of the politics that shaped and (just barely) achieved the passage of the Affordable Care Act (aka Obamacare) in 2010. The second half of the book is fascinating, a political thriller that (like Spielberg's "Lincoln") lays bare the grubby political maneuvering that allowed the achievement of a morally desirable end.

As a progressive Democrat, I had though that Obamacare did too little, and gave away too much to health-care interests. This book made it clear to me that, in 2010, the sort of health care reform that progressives wanted was not politically possible. It also made it clear to me that Obamacare was a major achievement that will have increasingly positive effects over time -- an achievement that now seems likely to remain in place.

Given the enormous amount that has been written on current U.S. health policy, it is hard to know where to turn for analysis. Paul Starr's resume suggests that this book is a good place to start. He is an eminent expert in the field of public policy. He is a professor of sociology and public affairs at the Woodrow Wilson School at Princeton, co-founded the liberal magazine "The American Prospect", and has written many books on public policy, including the Pulitzer winning "The Social Transformation of American Medicine". Despite his academic background, however, he writes in a real world political framework, and has the experience to back it up -- he was a senior advisor to President Clinton during the 1993 attempt to reform healthcare. Clearly, he has a liberal back- ground, but his analysis focuses on facts.

The first half of the book surveys efforts to reform U.S.
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3 of 3 people found the following review helpful By Chalmers M Nunn, Jr on February 13, 2012
Format: Hardcover Verified Purchase
This book helps continue the story Paul Starr began with his book The Social Transformation of American Medicine. A timely read.
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Format: Kindle Edition Verified Purchase
Professor Starr has demonstrated unparalleled mastery of the social history of health care in the US in his previous authoritative volume, The Social Transformation of American Medicine. As a physician with some limited work experience out of the country, I've been very gratified to learn, from his writing, why medicine is practiced so differently here than elsewhere.
This current work is a rigorous, detailed examination of the history of attempts to enlist the US society at large in the health care of its citizens, and includes a thoughtful explanation of how these efforts have been repeatedly derailed.
The book is to be valued especially for its account of the evolution of the Affordable Care Act. For example, I had forgotten -- or perhaps didn't pay attention in the passing of events -- such turning points as when candidate Obama changed his mind on the issue of the individual mandate.
Some may find their eyes glazing over with the recapping of events that transpired in Congress during these years, they are described in such detail. This is more than compensated for by the incisive and powerful summaries Starr provides in the introduction and in the concluding pages of the book.
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