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Remedy and Reaction: The Peculiar American Struggle over Health Care Reform, Revised Edition Revised Edition

4.3 out of 5 stars 10 customer reviews
ISBN-13: 978-0300189155
ISBN-10: 030018915X
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Editorial Reviews

Review

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

"[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 "

Winner of the 2011 PROSE Award in Government and Politics, as given by the Association of American Publishers.--Association of American Publishers"PROSE Award in Government and Politics" (02/02/2012)

"[A] remarkable chronicle of the hundred-year effort to legislate universal health insurance in the United States...." --Bernard Avishai, "The Nation"--Bernard Avishai "The Nation "

"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 "

"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 (06/17/2011)

""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 (06/14/2011)

"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 (06/06/2011)

"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 (06/02/2011)

"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 (06/27/2011)

"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 (06/28/2011)

" [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 "

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

"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./i>--Samuel Y. Sessions "Journal of the American Medical Association "

"[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 "

"[C]oncise and beautifully written."--Michael Gusmano, "Commonweal"--Michael Gusmano "Commonweal "

"[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 "

"Illuminating. . . This book provides one of the clearest descriptions and best justifications of the Affordable Care Act published to date...[An] excellent, cogently argued work."--Samuel Y./i>--Samuel Y. Sessions "Journal of the American Medical Association "

"[I]f I were forced to assign only one book to summarize the historical context, political constraints, and policy dilemmas that shaped the 2010 Patient Protection and Affordable Care Act (PPACA), I would definitely choose this tart and briskly paced 300-page work. I would do the same if I had to recommend one book to a well-informed colleague who obsessively followed the 2009 and 2010 legislative debate leading up to the PPACA. I was surprised by how much I learned reading Remedy and Reaction, as I was a close observer and partisan participant in that story."--Harold Pollack, "Public Administration Review"--Harold Pollack "Public Administration Review "

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" (02/02/2012)

About the Author

Paul Starr is professor of sociology and public affairs, Princeton University, and cofounder and coeditor of The American Prospect. His 1984 book The Social Transformation of American Medicine won the Pulitzer Prize for Nonfiction and the Bancroft Prize in American history. A senior advisor on health policy in the Clinton White House, he writes frequently on national politics.
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Product Details

  • Paperback: 360 pages
  • Publisher: Yale University Press; Revised edition (June 4, 2013)
  • Language: English
  • ISBN-10: 030018915X
  • ISBN-13: 978-0300189155
  • Product Dimensions: 1 x 6 x 9.5 inches
  • Shipping Weight: 15.2 ounces (View shipping rates and policies)
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (10 customer reviews)
  • Amazon Best Sellers Rank: #45,198 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By CJA VINE VOICE on June 8, 2013
Format: Paperback Verified Purchase
This is a succinct and subtle exploration of the long-time debate over nationalized healthcare in the U.S. and about why "Hilarycare" lost and "Obamacare" was enacted. The fundamental problem, which Starr calls the "policy trap", is that important segments of society get enough out of a woefully inefficient system to resist, and to be suspicious of, any reform. The deductibility of health insurance premiums by employers and nationalized healthcare for the elderly via Medicare means that the most important voting blocs in society do well under the system without really appreciating the ridiculously high cost of what they are provided. Middle class people with jobs and senior citizens vote -- and they are invested in the status quo.

Starr also probes into the darker side of American society -- the tolerance of suffering by others rationalized by the notion that I earned what I'm getting. Unlike any other advanced Western society, Americans question the right of citizens to get some minimum level of healthcare. And the polarization on this issue has gotten worse -- e.g., Starr cites polls showing that the percentage of Republicans who agreed with some such right has fallen from 37% to the low double digits.

While Starr does not espouse an explicitly Marxian message, the implication of his argument is that the healthcare debate is simply class warfare by other means. The political branches protect, respond to, and even subsidize the economically powerful in society, while the dispossessed are frozen out, and then are blamed for their own predicament (in American mythology all can be obtained by effort and hard work, so if you can't provide healthcare to your family it's only because you're not applying yourself).
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The United States has the most complicated and expensive healthcare system of any modern western industrialized nation. We also have the highest percentage of the population that goes uninsured. Why is this? In his book, Starr explained how we go to this point and why it has been so difficult to fix.
The efforts to reform healthcare in this country is nothing new. There have been various efforts and reforms since the New Deal era and other than a few notable exceptions, such as Medicare, Medicaid and prescription drug benefits that target certain segments of the population we have failed to cover everyone. Starr argues that it is these very reforms that doomed the efforts to broaden medical coverage to even larger segments of the population. By covering certain constituencies such as the elderly, children and the very poor while leaving others uncovered the American people were divided into different groups with very different personal interests when it coms to health care. Those that are already covered want to maintain the status quo for fear that their benefits will be impacted while those that are not covered are to few and political powerless to influence policy while at the same time driving up care for the covered through emergency care. Add to this the various interests from doctors, hospitals, and drug manufacturers and the nature of our legislative process and you get a history of thwarted reform.
In addition to giving the history of healthcare in the U.S., Starr does a very good job of explaining The Affordable Care Act (Obamacare) and putting it in the context of the previous 70+ years of attempts and failures to reform.
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Paul Starr wrote "The Social Transformation of American Medicine" in the early 1980s. It was a captivating and complete history of the forces that changed medicine and the medical providers up to 1980. In "Remedy," Starr - who was selected to be a participant in the Clinton medical study (now called Hillary Care) - related the events and challenges that were responsible for the failed attempt to develop a Governmental medical assistance bill in the Clinton administration. It is a fascinating read, and describes the situation well. Although it is clearly biased toward the agenda and political leanings of Hillary and that of her participants, (and thus against the Republicans who he thought were argumentative and unpatriotic), the history is valuable even for us who were not disposed toward the effort at that time. Although it appears that President Obama was more partial to the Nixon attempt (if you can believe it) in Obamacare,the Hillary effort was very instrumental in generating support from those who killed the Hillary bill (namely the insurance industry.) Remedy is a fascinating and necessary read for those who want to understand the genesis of Obamacare.
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Paul Starr lists the many failed attempts at health care reform in American history.
He explains why they failed and describes some of the benefits included.
The author also gives detailed insight into the political landscape and circumstances that led to failure, particularly in the Nixon and Clinton eras.

This is a partisan book but the author, I think, stayed civil while writing about the conservative strategies and figures on that side of the aisle.

Very good reading and well written.
I came away with a better understanding of the Affordable Care Act and why health care reform has been so hard to achieve.
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