Health Care Politics and Policy in America, written by Kant Patel and Mark E. Rushefsky is a lengthy tome. Nonetheless, it is a must read for any one wanting to learn about the American health care system. The two authors wrote in 1999 predating President Obama's recent reform initiative. However, they chart the development of health care as Americans know it today. It is in eleven chapters--and some three hundred pages--that the two authors chart American health care, beginning in an overview of governmental health care policy.
They described the situation in the nineteenth century how limited government--on the federal level--- prevailed and that the public turned to local and state authorities, as well charitable organizations to ensure access to health care. The medical profession suffered in this environment as they were no set standards in educating doctors and pharmacists, and they were compensation for their services were sparse. In addition, medical infrastructure--hospital and clinics--were numerous in and around metropolitan areas, but few and far between in rural areas. Limited government gave way to positive government as Americans demanded that Washington intervene in the crisis of the Great Depression. FDR originally proposed a national health insurance program, but it fell to the wayside lest it jeopardize the entirety of his New Deal initiatives.
In lieu of national health insurance, the federal government encouraged state and local authorities to build hospitals and expand health coverage. Federalism, the authors contended, as well as reliance on the private sector, have thwarted definitive national solutions to health care. Medicare and Medicaid only provide health coverage for a fraction of society, while private workplace based benefits cover a majority. Unfortunately, there is a sizable segment of society that has slipped through the metaphorical cracks.
Katel and Rushefsky, in their text, also discuss the shortcomings of American health care. The rising cost of health care has forced the federal and state government to curtail Medicare and Medicaid expenditures. Medical malpractice, and the ensuring litigation, have also made the practice of medicine very expensive. Medicare and Medicaid, in the opinion of the authors, have shifted from an entitlement of need to the entitlement of the middle class. Again, reforms to health care have fallen on deaf ears as as American stakeholders fear that an overhaul will disadvantage many.
If one wants to educate themselves on the development of American health care policy, then Patel and Rushefsky's text would be a great starting point.
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