The Inside Story of a Century-Long Battle
September 5, 2011
In this level-headed look at health care policy, Altman (a major player in reform efforts since the 1970s) and freelance writer Shactman tease out the paradoxes from the politics, arguing that there can be no functioning health care system without federal involvement. Fear of government-run health care has produced the world's most expensive system, which has parceled out coverage for the poor, the elderly, AIDS patients, and children, while leaving millions of others without options. Though Democrats like the late Sen. Edward Kennedy made health care their life's mission, it was Richard Nixon who tried twice to enact universal health care, only to be undone, in part, by scandal. Bill Clinton made the next serious attempt but crashes and burns, never getting support from Congress for his complex, revolutionary "managed competition" plan. In an ironic twist, Barack Obama finally secures the reforms (such as eliminating exclusions for pre-existing conditions) that Nixon and other Republicans sought, without making Clinton's political mistakes. The alphabet soup of health care jargon is made more palatable by a convenient glossary and a light sprinkling of anecdotes involving Altman's late mother who once asked: "Who designed this crazy system?" This eminently accessible study offers the answers.