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(More customer reviews)In this short book, Professor Rick Mayes explores the question of why, thus far, the United States does not have universal medical health care coverage. His approach is historical. He looks at the issue from the Administration of Franklin Roosevelt down to that of George W. Bush. His conclusions make a great deal of sense, but, as far as I know, have not been argued before.
First, he uses the social science concept of "path dependency." Broadly, that means that, when the country goes down one path, it has a tendency to continue on that path and that other paths are made less likely. Mayes argues that FDR's decision to create Social Security was critical for the nation's social policy. This split social coverage, in two, with Social Security on the public path and medical insurance, on the private path. As both Social Security and private insurance grew, they developed vast institutional networks, with huge numbers of people dependent upon them. As these grew, they became harder to change, because so much many were tied into them.
Second, Medicare was created in 1965 with no cost controls of any kind. This resulted in the entire system becoming so expensive that: (a) it became politically very difficult to expand, because it was already so expensive; and (b) everyone's energy became focused on cost control, not on universal care.
This is a model book of this type. Mayes writes clearly and concisely. He knows this stuff. His policy preferences are conventional liberal, but his understanding of the system is far beyond the ordinary.
Click Here to see more reviews about: Universal Coverage: The Elusive Quest for National Health Insurance (Conversations in Medicine and Society)
Why is the United States the only major industrialized nation without universal health insurance coverage? Why have so many efforts to pass a national health insurance plan failed? Many observers argue that this glaring peculiarity of American social policy is due to the superior lobbying efforts of the American Medical Association, a general weakness on the part of the federal government, or, more generally, America's cultural sense of rugged individualism. This book argues that there is actually no one politics of health care or single explanation for the lack of universal coverage; there are, instead, different patterns of politics at different stages of policy development. Throughout these stages, however, a unique and critical relationship has existed between Social Security and the development of health insurance. In Universal Coverage, Rick Mayes analyzes how the fate of Social Security and Medicare became commingled and how myriad elected leaders, interest groups, and organizations invested in the existing arrangements have effectively prohibited comprehensive change to America's medical industrial complex.--This text refers to an out of print or unavailable edition of this title.
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