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

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Power, Politics, and Universal Health Care: The Inside Story of a Century-Long Battle ReviewThe authors manage to make readers feel like they are sitting in on key high level meetings on health care reform- whether with key senators, President Nixon or President Clinton. It is mind boggling that these efforts spanned multiple presidencies, and that Stuart Altman has been working on many of these efforts for all of these years. Altman and Shactman take us on remarkable journey of health reform, leading into the somewhat improbable passage of health reform in 2010. Despite the extraordinary amount of fascinating details, this book is eminently approachable and highly readable-- more like a novel than a dry policy text. Anyone interested in understanding how the many subtle and not so subtle competing forces derailed past attempts at health reform will be interested in this book. Those of you interested in feeling like you've wrangled front row seats to one of the most vexing public policy and political questions of the past forty years will also find tremendous value in this book. Highly recommended.
Power, Politics, and Universal Health Care: The Inside Story of a Century-Long Battle OverviewForeword by Senator John Kerry
Why was the Obama healthcare plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and advisor to five US presidents—and fellow healthcare specialist David Shactman explain not only the Obama plan but 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 historical perspective.
The authors describe the sometimes haphazard, piece-by-piece construction of the nation's healthcare 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 machinations that brought about immense shifts in policy or thwarted herculean efforts at reform.
For example, few people know that Richard Nixon marshaled the best attempt to enact universal health care; or that he arranged secret health policy meetings in the basement of a Washington church with aides to Ted Kennedy. Who knew that the American Medical Association (AMA) publicly questioned the Surgeon General's report that tobacco was harmful in order to defeat the Medicare bill, or that three different sex scandals obstructed the road to universal health care?
Altman and Shactman look at key moments in healthcare history: the Hill-Burton Act, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three layer cake" strategy of Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan and then repealed because of public anger; the story of how the largest and most expensive expansion of Medicare was enacted by George W. Bush.
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 for nearly a hundred years.
Written in a lively and informative narrative Power, Politics, and Universal Health Care will indulge the casual and curious reader as well as physicians, nurses, hospital administrators, and the student of healthcare policy. Based on the long experience of Stuart Altman, who was a key participant at several critical junctures in the history of health reform, this book provides personal stories and insights never revealed before. Essential reading for every American who someday must navigate the U.S. healthcare system.

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