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Summary: Starr review
Review: A very accesible read. It easily combined my interest in social history and health care.
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Summary: "Promote The General Welfare"-Preamble, U.S. Constitution
Review: Another spring cleaning survivor!!! It's dated but extremely good and incredibly comprehensive. The author was a Sociology Professor at Harvard in 1982 when he wrote this book, he is now at Princeton. This book won several awards in 1984, one of which was a Pulitzer Prize. Of course, much has changed in health care in the 22 years since then, but this book is decidedly foundational for understanding the whole health care issue.
The book begins with the genesis of organized American medical practice in the late 1700's modeled somewhat on the English system and ends with the complex system that was operational in 1982 based upon the corporation. The emergence of the AMA, Medicare, Medicaid, HMOs, and medical insurance providers are all documented.
The book is a non-partisan piece as he states in his preface "The reader who expects to find a political program here will be disappointed." However, this book made me appreciate Senator Kennedy for his work on the issue of national health care. How that issue fared/evolved within the various administrations and congresses is detailed in the later chapters. As this example summarizes the political climate in the early 70's, Starr writes that "the laws (health policy) were especially detailed because of Democratic reluctance to trust the Nixon administration with much discretion. Some were so severely compromised in passage as to be nearly unworkable. And each provoked bureaucratic conflict and litigation that took years to resolve...In 1974-75 a severe economic recession, accompanied by soaring inflation, arrested new initiatives to expand medical care and other social programs." Hmm...
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Summary: Great history of American medicine
Review: For anyone interested in the healthcare as a profession or area of study, I can't recommend this book highly enough. Despite the 20 years since its publication, Paul Starr's Pulitzer prize winner is still relevant today and in retrospect his projections made of the future of healthcare in America are surpisingly prescient. The first book describes the development of the medical profession in early America providing a fascinating look at the social evolution of American society. The second book delineates the rise of doctors, hospitals and medical schools in latter half of the 19th to the early 20th century with the rise of science and a professional authority. The third book shifts the focus from the doctors and to the industry that medicine became as well as the various attempts at healthcare reform in response to rising healthcare costs. My only criticism is that Starr should have devoted more pages to the root causes behind the rising healthcare costs that drove the reforms of the 1960-70s described in the third book.
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Summary: A Comprehesive History
Review: It was a pleasure to read Starr's enlightening, comprehensive journey of medicine in it's infancy to it's state in 1985. I hope to see an updated version filling in the intervening 17 years. An excellent book. I highly recommend it.
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Summary: Blame it on the AMA
Review: This book traces the evolution of America's disjointed healthcare system, from the horror of the early hospitals to the formation of the medical profession. It also explains how, as the early profession was fighting for the right to exist, it took virtual possession of the rest of the healthcare system. Every Democratic president since FDR has attempted some type of major healthcare reform, only to be opposed by the American Medical Association (AMA) because organized doctorhood thought it had too much to lose. This book is an effortless read for students of sociology or those that have a great interest in the history of medicine. Published in 1983, it easily predicts some of the current problems in American healthcare, because the powerful interests that determine the delivery of healthcare are still the same. It also predicts some of the circumstances that will finally bring America around to some sort of rational, universal, healthcare coverage.
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Summary: Why the US has a private health care system
Review: This Pulitzer Prize winning history of American Medicine does a lot to explain why the domain of public health is so small in the U.S., and why health in the U.S. is mostly a private, as opposed to public, matter. It takes some fortitude to get through, but it should be required reading for anyone who has ever wondered why, for better and for worse, the US is the only developed country that does not have social provision of medical care. Hint: It's not an accident. Recommended
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