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

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New Haven and London 2011 Hardcover 336 pages. Hardcover with dustjacket. Brand new book. HEALTH. In no other country has health care served as such a volatile flashpoint of ... ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues. Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change. He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990s&emdash; and of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt Romney's reforms in Read more Show Less

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Overview

In no other country has health care served as such a volatile flashpoint of ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues.

Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change.

He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990s—and of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt Romney’s reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continues—a penetrating account of how health care became such treacherous terrain in American politics.

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Editorial Reviews

Publishers Weekly
In this remarkable history, Yale sociologist and Pulitzer Prize–winner Starr (The Social Transformation of American Medicine) says that America's contradictions (the opposing values of egalitarianism and self-reliance) are nowhere more evident than in the rancorous history of health care reform. Unlike citizens in other rich capitalist countries, Americans equate public responsibility for health care with a loss of freedom, while health care reformers and critics alike play on our distrust of Big Insurance and Big Government. There couldn't be a more astute insider to the politics of reform than Starr; some of his most riveting elements draw on his experience working on the Clinton administration's health care push, as well as his sharp critique of Obama administration reforms: "Obama would go from a position that was good politics but bad policy during the election to a position that was good policy but bad politics when he was president...." 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. (Oct.)
Huffington Post
[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
Washington Monthly
[Starr's] unsentimental perspective serves him well in this outstanding volume.—Harold Pollack, Washington Monthly

— Harold Pollack

The Nation
[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

Association of American Publishers
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

Booklist
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

The Incidental Economist
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 Charlotte Observer
[D]elivers an insightful political analysis.—Kristen Greencher, The Charlotte Observer

— Kristen Greencher

Science
"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
Boston Globe
[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

Health Affairs
“Engrossing.”—HealthAffairs
Commonweal
[C]oncise and beautifully written.—Michael Gusmano, Commonweal

— Michael Gusmano

Journal of the American Medical Association
“Excellent, cogently argued.”—Journal of the American Medical Association
Huffington Post - Glenn C. Altschuler
"[A] clear, comprehensive, and compelling chronicle of the health care debate....Starr is at the top of his game."—Glenn Altschuler, Huffington Post
Washington Monthly - Harold Pollack
"[Starr's] unsentimental perspective serves him well in this outstanding volume."—Harold Pollack, Washington Monthly
Association of American Publishers - PROSE Award in Government and Politics
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
Booklist - Donna Chavez
"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)
The Incidental Economist - Austin Frakt
“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
Henry Aaron
“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
Timothy Jost
"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
 
Jonathan Cohn
"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
Robert B. Reich
"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
Norman Ornstein
"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
Shannon Brownlee
"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
The Charlotte Observer - Kristen Greencher
"[D]elivers an insightful political analysis."—Kristen Greencher, The Charlotte Observer
The Nation - Bernard Avishai
“ [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
Boston Globe - Dennis Rosen
"[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
Health Affairs - Jeff Goldsmith
"[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
Commonweal - Michael Gusmano
"[C]oncise and beautifully written."—Michael Gusmano, Commonweal
Journal of the American Medical Association - Samuel Y. Sessions
"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
Library Journal
Starr (sociology & public affairs, Princeton Univ.), who won the Pulitzer Prize almost 30 years ago for The Social Transformation of American Medicine, now recounts the long and largely unsuccessful fight to provide all Americans with health care. Early 20th-century progressives began the struggle, FDR tried halfheartedly during the New Deal, and even Richard Nixon supported national health care. Finally, a century later, President Obama, borrowing Mitt Romney's individual mandate and leaving out the public option, passed health-care reform that doesn't satisfy progressives and that socializes medicine, according to right-wing critics. Starr shows how the window of opportunity for health-care reform has opened several times in the last 100 years and how each time it has been slammed shut by powerful interests including the American Medical Association, big insurance companies, and the conservative politicians they support. Starr argues that the "protected public"—those with job-based insurance and recipients of government coverage—prevents major reform because enough Americans have some coverage to fear the consequences of change. VERDICT This is a must-read in order to understand why health-care reform has been and continues to be so difficult to achieve in America.—Duncan Stewart, Univ. of Iowa Libs., Iowa City
Timothy Noah
…compact but thorough…an unofficial companion volume to [Starr's] Pulitzer Prizewinning 1982 book, The Social Transformation of American Medicine
—The New York Times Book Review
Public Administration Review
[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

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Product Details

  • ISBN-13: 9780300171099
  • Publisher: Yale University Press
  • Publication date: 10/25/2011
  • Pages: 336
  • Product dimensions: 6.40 (w) x 9.40 (h) x 1.20 (d)

Meet the Author

Paul Starr is professor of sociology and public affairs, Princeton University, and co-founder and co-editor 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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