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Why the U.S. Has No National Health Insurance

by Jill Quadagno

Pub Date: April 1st, 2005
ISBN: 0-19-516039-8
Publisher: Oxford Univ.

Every one of the Western industrialized powers guarantees its citizens comprehensive coverage for essential health care—except the United States. Sociologist Quadagno (The Color of Welfare, 1994) ably explores the logic behind this appalling fact.

It’s a complex question, as Quadagno allows: Amortization and other risk-analysis models mingle with myriad underwriting plans and the plain high cost of medical care to make comprehensive health care a maddeningly elusive goal. And then, of course, the powers that be don’t want it. It is for those reasons, but not those reasons alone, that so many Americans lack basic coverage—and their numbers are larger by far than the official count of 45 million in 2003, “because many more people are uninsured for some period over any two-year time span.” The poor are almost always uninsured, except under the most generalized of plans; in a two-year span, nearly 60 percent of non-elderly Hispanics were also uninsured, as against 43 percent of African-Americans and 23 percent of whites. Part of the problem is that minorities are less likely than whites to have jobs that offer health care benefits. But attempts to include all Americans in a national plan have been stymied for more than a century. Heroes are few and villains many here. When Franklin Roosevelt attempted to include health insurance in the 1935 Social Security Act, the American Medical Association successfully argued that it “smacked of socialism and communism and might incite revolution.” When Harry Truman and Dwight Eisenhower attempted health care reforms during their administrations, they met much the same opposition, this time with the strong backing of the insurance industry. And, as Quadagno relates, the present administration is indisposed toward any reform that would threaten the status quo, period, even as the average annual cost of a family policy in 2003 rose to $9,068.

A strongly argued account that provides useful ammunition for anyone seeking to effect change in a medical system that willfully excludes so many who so need it.