Grow and Hide: The History of America's Health Care State

by Colleen M. Grogan

Overview

A sweeping history of the American health care state that reveals the public has been intentionally misled about the true role of government.

The US government has always invested federal, state and local dollars in public health protection and prevention. Despite this public funding, however, Americans typically believe the current system is predominantly comprised of private actors with little government interference. In Grow & Hide, Colleen M. Grogan details the history of the American health care state and argues that the public has been intentionally misled about the true role of government.

The US created a publicly financed system while framing it as the opposite in what Grogan terms the "grow-and-hide regime." Today, the state's role is larger than ever, yet it remains largely hidden because stakeholders-namely, private actors and their allies in government-have repeatedly, and successfully, presented the illusion of minimal government involvement. The consequences of this narrative are scarce accountability and a highly unequal distribution of benefits.

In the wake of a pandemic that has killed over one million Americans—with the highest death rates among minorities and lower-income people—the time has come for an honest discussion about the health care system. As Grogan reveals, America has never had a system that resembles a competitive, free-market model. Given how much the government already invests in the health care system, means how these funds are distributed and administered are fundamental political questions for the American public, not questions that should be decided by the private sector. If we want to fix care in America, we need to reimagine the way it is organized, prioritized, funded, and, perhaps most importantly, discussed. Grow & Hide is an important contribution to this reimagining.

Product Details

ISBN-13:	9780199812233
Publisher:	Oxford University Press
Publication date:	09/08/2023
Pages:	448
Product dimensions:	9.34(w) x 6.49(h) x 1.43(d)

About the Author

Colleen M. Grogan is the Deborah R. and Edgar D. Jannotta Professor at the University of Chicago. Grogan's research focuses on health policy and politics with a primary focus on the US health care system and its complex entitlement programs. She is the author of Healthy Voices/ Unhealthy Silence: Advocacy and Health Policy for the Poor and numerous articles that focus on elite decision-making around America's Medicaid program and offer a fundamentally new way to view the politics of the program. She is an elected member of the National Academy of Social Insurance and served on its COVID-19 Policy Translation Task Force. Grogan's work has been covered by The Washington Post, NPR, and The Guardian.

Table of Contents

Introduction: America's Expanding, Unequal and Hidden Health Care State

Part I: The Emergence of a Public Health Care State: 1860-1930
Chapter 1: A Conspicuous Public Health Care State
Chapter 2: Expanding the Boundaries of Public Health
Chapter 3: Public Health Planning: Hope for a Unified Public-Private System

Part II: The Rise of Grow & Hide: 1930-1965
Chapter 4: The New Public Health Deal
Chapter 5: The Voluntary Way Hides the Role of Government
Chapter 6: Solidifying the Grow and Hide Approach

Part III: The Consequences of Grow & Hide: 1965-2020
Chapter 7: Fragmentation: The Failure of Health Care Planning
Chapter 8: Profiteering: The Hidden Financial Industry Takeover
Chapter 9: Inequality: How Medicaid is Designed to Grow and Hide
Chapter 10: The ACA Embraces Grow & Hide

Conclusion: Possibilities for Change
Notes
Index

Editorial Reviews

"This blockbuster book excavates a buried truth: Health care in America is organized, constructed, and paid for by the government. Why don't Americans know that? Because, as Colleen Grogan meticulously shows, the government hides its pervasive hand. Grow and Hide is an extraordinary detective story tracing the many hidden forms of public action—and the unjust ways they tilt the system. Beautifully written, deeply researched, endlessly fascinating, and extremely important." — James A. Morone, Brown University, and author of Hellfire Nation

"In this magisterial account, health policy expert Colleen Grogan puts forth the most ambitious, wide-ranging analysis of the American health care system in a generation. She shows how the myth of a predominant private sector emerged, how it hides the government's vast role, and how it is fanned for great profit by a multitude of health sector actors, most recently private equity. Along the way, she illuminates important facets of health policy that the usual accounts miss but that are patterned by the same rhetorical myth. Grogan offers an insightful, original account of the American health care tragedy: spending so much, getting so little in return." — Andrea Louise Campbell, Massachusetts Institute of Technology, and author of Trapped in America's Safety Net

"Grow and Hide uncovers the hidden paradox at the heart of America's health crisis: public and private leaders celebrate the 'private' medical sector even as government at all levels props it up, makes the public health investments it shortchanges, and finances the lion's share of its exorbitant costs. To fix this giant mess, we must see it—and Colleen Grogan brilliantly brings its full scope out of hiding." — Jacob S. Hacker, Yale University, and author of The Great Risk Shift

"Grow and Hide is deeply informed and indispensable reading. Colleen Grogan masterfully debunks fundamental and self-undermining myths about the historical development, contemporary structure, financing, and politics of US health care and public health. Her poignant and creative recasting of health policy offers novel insights that are critical for envisioning a more healthy and equitable future—especially for those who are most vulnerable." — Jamila Michener, Cornell University, and author of Fragmented Democracy

"In this compelling book, Grogan synthesizes and augments several generations of scholarship on the history of organizing and financing healthcare in the United States since the early twentieth century. She demonstrates that the growing size and effectiveness of the health sector has been, primarily, a result of public policy and funding that has been obscured by mythology that exaggerates the role of individuals and organizations in the private and non-profit sectors. Grow and Hide is a significant contribution to the literature on the history of what Grogan describes, appropriately, as the American health care state." — Daniel M. Fox, President Emeritus, Milbank Memorial Fund

"Grow and Hide is that extreme rarity - a book that makes both a stellar addition to scholarship and an admirable contribution to democratic theory and practice. Enriched by Grogan's work, as penetrating as it is provocative, scholars of public health and public policy - and indeed open-minded citizens wherever they may be found - will be better equipped to interpret the import of the policy history it reveals and to ponder the range of political responses those revelations may call to mind." — Lawrence D. Brown, Books & Media

From the Publisher