Power, Politics, and Universal Health Care: The Inside Story of a Century-Long Battle

Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman-internationally recognized expert in health policy and adviser to five US presidents-and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation's health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill-Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.

Author: Stuart Altman, David Shactman
Publisher: Prometheus Books
Published: 09/20/2011
Pages: 429
Binding Type: Hardcover
Weight: 1.55lbs
Size: 9.10h x 6.30w x 1.30d
ISBN: 9781616144562


Review Citation(s):
Publishers Weekly 09/05/2011
Choice 04/01/2012

About the Author
Stuart Altman, the Sol C. Chaikin Professor of National Health Policy at the Heller School for Social Policy and Management, Brandeis University, is an internationally recognized expert in health policy. He served as a deputy assistant secretary of Health, Education, and Welfare in the Nixon administration and was one of the architects of Nixon's plan for universal health care. He was chair of the Prospective Payment Assessment Commission (ProPAC) for twelve years under presidents Ronald Reagan, George H. W. Bush, and Bill Clinton. ProPAC was responsible for overseeing the way Medicare paid hospitals and other health institutions. He also served on President Clinton's transition team and was appointed to the president's Bipartisan Commission on the Future of Medicare. Recently, he was a member of the health policy team for Barack Obama during his presidential campaign.

David Shactman is a freelance writer who was a senior fellow at the Schneider Institute for Health Policy at the Heller School for Social Policy and Management, Brandeis University, and worked with Stuart Altman for eleven years. During that time, he was coeditor of two books: Policies for an Aging Society (with Stuart Altman) and Regulating Managed Care (with Stuart Altman and Uwe E. Reinhardt). He has also written numerous articles published in peer-reviewed journals and trade magazines, including Health Affairs and the New England Journal of Medicine.


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