Beginnings Count: The Technological Imperative in American Health Care / Edition 1

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Overview

In the wake of the recent unsuccessful drive for health care reform, m any people have been asking themselves what brought about the failure of this as well as past attempts to make health care accessible to all Americans. The author of this original exploration of U.S. health pol icy supplies an answer that is bound to raise some eyebrows. After a c areful analysis of the history and issues of health care, David Rothma n concludes that it is the average employed, insured "middle class"—t he vaguely defined majority of American citizens—who deny health care to the poor.

The book contains no figures.

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Editorial Reviews

Doody's Review Service
Reviewer: Conevery A. Bolton, BA (Harvard University)
Description: Historian David Rothman traces the ways in which middle-class demand for high-tech medical interventions has shaped the course of American medicine in the twentieth century.
Purpose: This book grapples with a central question of contemporary American life: how is it that a country with an extremely high level of skilled technological intervention in the ailing human body countenances the vast inequity of access to basic and complex health services?
Audience: This book will be of interest to medical professionals and historians as well as to members of the public interested in the historical roots of contemporary dilemmas over health insurance, managed care, and the role of the federal government in American healthcare.
Features: Six chapters, arranged chronologically, highlight turning points in medical technology, access to health services, and national vs. private responsibility for the expenses of healthcare. Successive chapters discuss the beginnings of Blue Cross in the 1930s, provision of iron lungs in the 1940s and 1950s, debates over Medicare in the early 1960s, federal assumption of the costs of kidney dialysis in the early 1970s, the advent of the respirator in the last third of this century, and the Clinton health plan of the early 1990s. The book's index is useful, and the print quality is good.
Assessment: Rothman's argument is nuanced and historically informed; his writing is clear and straightforward; and his conclusion, that technology in American medicine has been intimately connected with increasing inequality, is thought-provoking and unsettling. Beginnings Count wields a sharp argument, but no bombast. Although Rothman implicitly assails the failure of American medicine to widen access to healthcare, especially technological interventions, to those below the "middle classes," he does so in measured arguments and careful prose, backed up by scholarly research and occasionally enlivened by dry wit.
Conevery A. Bolton
Historian David Rothman traces the ways in which middle-class demand for high-tech medical interventions has shaped the course of American medicine in the twentieth century. This book grapples with a central question of contemporary American life: how is it that a country with an extremely high level of skilled technological intervention in the ailing human body countenances the vast inequity of access to basic and complex health services? This book will be of interest to medical professionals and historians as well as to members of the public interested in the historical roots of contemporary dilemmas over health insurance, managed care, and the role of the federal government in American healthcare. Six chapters, arranged chronologically, highlight turning points in medical technology, access to health services, and national vs. private responsibility for the expenses of healthcare. Successive chapters discuss the beginnings of Blue Cross in the 1930s, provision of iron lungs in the 1940s and 1950s, debates over Medicare in the early 1960s, federal assumption of the costs of kidney dialysis in the early 1970s, the advent of the respirator in the last third of this century, and the Clinton health plan of the early 1990s. The book's index is useful, and the print quality is good. Rothman's argument is nuanced and historically informed; his writing is clear and straightforward; and his conclusion, that technology in American medicine has been intimately connected with increasing inequality, is thought-provoking and unsettling. Beginnings Count wields a sharp argument, but no bombast. Although Rothman implicitly assails the failure of American medicine to widenaccess to healthcare, especially technological interventions, to those below the ""middle classes,"" he does so in measured arguments and careful prose, backed up by scholarly research and occasionally enlivened by dry wit.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780195111187
  • Publisher: Oxford University Press, USA
  • Publication date: 5/28/1997
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 208
  • Product dimensions: 5.75 (w) x 8.44 (h) x 0.81 (d)

Meet the Author

David J. Rothman is Bernard Schoenberg Professor of Social Medicine, Professor of History, and Director of the Center for the Study of Society and Medicine at the Columbia College of Physicians and Surgeons. Trained in social history at Harvard University, he has explored American practices toward the deviant and dependent. In 1987 he received an honrary Doctor of Law degree from the John Jay School of Criminal Justice. In 1983 he joined the Columbia medical school faculty and his recent work has addressed the history of bioethics and human experimentation along with the social policy implications of organ donation and care at the end of life. Among the books he has authored are The Discovery of the Asylum (1971) and Strangers at the Bedside (1991). He has also co-authored The Oxford History of the Prison (1995).

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Table of Contents

Introduction 3
1 Blue Cross and the American Way in Health Care 15
2 The Iron Lung and Democratic Medicine 41
3 Medicare for the Middle Class 67
4 Dialysis and National Priorities 87
5 Rationing the Respirator 111
6 No Limits 133
Epilogue 157
Notes 167
Index 183
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