Mother of Invention: How the Government Created "Free-Market" Health Care

by Robert I. Field

Overview

By relying on private enterprise more than any other developed nation, American health care has all the appearances of the free-market in action. And for more than a hundred years, attempts to reform this system (including President Obama's Affordable Care Act) have been met with opposition from parties warning against the stifling effect of government intervention.

What these warnings about federal intrusion overlook is the fact that the federal government has long been an indispensable player in guiding and supporting the current US health care system. Its role is so pervasive and of such longstanding importance that it is easy to overlook, but it actually created American health care as we know it today.

Seminal public programs stand behind every segment of America's massive and hugely profitable health care industry. This is not to deny the instrumental roles of private entrepreneurship and innovation, but rather to describe the foundation on which they rest. The industry's underlying driving force is a massive partnership between the public and private spheres. The partnership is complex, and its effects are not always ideal. But for better or worse, it shapes every aspect of what we in the United States know as health care.

Mother of Invention traces the government's role in building four key health care sectors into the financial powerhouses they are today: pharmaceuticals, hospitals, the medical profession, and private insurance. It traces their history, surveys their growth, and highlights some of their greatest success stories, which together reveal the indispensable role of public initiatives in contemporary private health care.

Only by understanding what actually drives our system can we appreciate possibilities for meaningful reform or comprehend the true context—historically and politically—of the Obama plan.

Product Details

ISBN-13:	9780199746750
Publisher:	Oxford University Press
Publication date:	11/29/2013
Edition description:	New Edition
Pages:	336
Product dimensions:	6.10(w) x 9.30(h) x 1.20(d)

About the Author

Robert I. Field is Professor of Law and Professor of Health Management and Policy at Drexel University and Lecturer in Health Care Management at the Wharton School of the University of Pennsylvania. He has written extensively on the American health care system and has authored a comprehensive overview of health care regulation, Health Care Regulation in America: Complexity, Confrontation and Compromise (also published by Oxford University Press). He has also practiced health law and worked in the management of a major academic health system. He is a frequent media commentator on health care issues and has been quoted by NPR, CNN, ABC News, New York Times, Wall Street Journal, and numerous other outlets. He writes a regular blog on health policy for The Philadelphia Inquirer entitled "The Field Clinic."

Table of Contents

Preface

Chapter 1 - What's Private About the Free Market?

Chapter 2 - The Government and the Private Market in Health Care

Chapter 3 - How the Government Created the Pharmaceutical Industry

Chapter 4 - How the Government Created the Hospital Industry

Chapter 5 - How the Government Created the Medical Profession

Chapter 6 - How the Government Created Private Health Insurance

Chapter 7 - The Distinctively American System that the Government Created

Chapter 8 - Health Reform, Government Initiative, and the Future of American Health Care

Selected Bibliography

Notes

Editorial Reviews

Reviewer: Carole A. Kenner, PhD, RN, FAAN, FNAP, ANEF (The College of New Jersey)
Description: This book attempts to explain healthcare reform and how government is so inextricably linked to healthcare that to separate the two would be impossible and unwise.
Purpose: It provides a historical context for the current debates about the role of government and the private sector in healthcare. It examines the four healthcare system components — the pharmaceutical industry, hospitals, the medical profession, and private insurance industry — to give insights into the role government has played in each of these areas. Regulation is perceived by many to be an external force that safeguards citizens and keeps private companies in check, but the author contends this perception is not accurate.
Audience: Health policy students, health professionals and students, as well as public policy students and those interested in policy will find the book useful.
Features: A discussion of the debate about the private sector and free markets and how private companies really drive the healthcare system begins the book. The impact of technology demonstrates the link between the Internet, the evolution of electronic medical records, and healthcare. The next sections delve into the pharmaceutical industry, hospital industry, medical profession, private health insurance, and how the government created the U.S. healthcare system. The unique features of these chapters reside in the presentation of the material from the historical roots to today's healthcare system and how private and government partnerships shape healthcare. The final chapter is an overview of the historical roots of healthcare reform, starting in the early 1900s and ending with what can be expected in the future as "Obamacare" evolves. Inclusion of copious notes in an additional section gives curious readers a more in-depth discussion of the issues.
Assessment: There are many books about healthcare reform, but none that explore the topic of the role of government and the partnership with private companies the way this one does. Its unique spin on how government cannot ever be totally separate from healthcare delivery provides great material for debates.

Doody's Review Service

"Robert Field begins with the familiar cry, 'keep government out of my health care,' and skillfully demonstrates why that is simply not possible. Government is the silent partner driving the health care system—organizing, regulating, and funding, funding, funding. Mother of Invention reveals the private—public connection in every corner of American health care-from the pharmaceutical giants to the family doctor. It is elegant, thoughtful, creative, meticulous, unsettling, irresistible, and required reading for both scholars and citizens." -James Morone, John Hazen White Professor of Political Science and Public Policy, Brown University, and author of Hellfire Nation, By the People: Debating American Government and The Heart of Power: Health and Politics in the Oval Office

"Weaving history and crisp analysis, Professor Field brilliantly helps us to understand how government's massive roles in policy, payment and regulation have created the exigencies of the American health care system and its marketplace. His conclusions affirm that this reality will shape all viable solutions going forward." — Gary L. Gottlieb, President and Chief Executive Officer, Partners HealthCare System, Inc., and Professor of Psychiatry, Harvard Medical School

"This book offers a brilliant analysis of the enduring role of government in creating and supporting the health care market. It is a must-read for anyone who wants to understand the true relationship between government and market forces." — Sara Rosenbaum, Harold and Jane Hirsh Professor, George Washington University School of Public Health and Health Services

"Robert Field's illuminating book demonstrates the fatuity of calls to get the federal government out of our health care system. Through generous funding, tax breaks and protective regulation, the federal government in fact created our uniquely American public/private health care system, which could not have existed without it. Our task now, as Field shows, is to improve, not sunder, this relationship." — Timothy Stoltzfus Jost, Robert L. Willett Family Professor, Washington and Lee University Law School

"Field's investigation is compelling, his subject is vast and daunting. We come away knowing that the system is a delicate dance between the private and public sectors. It is the reason we have some of the best care in the world and why our system is the most expensive." —Philadelphia Inquirer

"Though Barack Obama is the first American president to succeed in passing a universal health-care plan, in his new book Mother of Invention, Drexel University law professor Robert I. Field reminds us that the idea of a national health plan isn't anything new. The book's central premise is that the government created the health-care system, often in hidden ways, and without it, we would not have the system we have. Though Field's investigation is compelling, his subject is vast and daunting. But in Field's view, the Affordable Care Act is a step in the right direction." — Evi Heilbrunn, The Inquirer

"There are many books about healthcare reform, but none that explore the topic of the role of government and the partnership with private companies the way this one does. Its unique spin on how government cannot ever be totally separate from healthcare delivery provides great material for debates." -Doody's

"This book stands as an excellent review of the history and current state of the U.S. health-care system. ... This book is a valuable addition to the literature on the U.S. health insurance system, and comparative studies that aim to relate the U.S. health insurance system to those of other countries to determine which policies work best for improving health care and health insurance." —Journal of Risk and Insurance

"In a methodical fashion, Field explains how the government created the pharmaceutical industry, the hospital industry, the medical profession, and private health insurance. Recommended." —CHOICE

"This book is a valuable addition to the literature on the U.S. health insurance system, and comparative studies that aim to relate the U.S. health insurance system to those of other countries to determine which policies work best for improving health care and health insurance." — Journal of Risk and Insurance

"Mother of Invention is a thoughtful examination of the dynamic between government and business and how it has shaped health care as we know it. These forces will continue to conspire and determine the future course of health care for worse and, let's hope, for better." - Health Affairs

From the Publisher