REMEDY AND REACTION

Starr provides a roadmap to the evolution of the health-care debate, a profile of participants and an explanation and interpretation of ideological jargon in a readable way.

Pulitzer winner and American Prospect co-founder Starr (Sociology and Public Affairs/Princeton Univ.; Freedom's Power: The True Force of Liberalism, 2007, etc.) is a leading expert on health care and a former advisor to the Clinton White House. Here he provides an overview of the “peculiar” efforts to legislate on health care in the United States. He uses “peculiar” to distinguish American practice in the area from that of other countries, to discuss the specific ways in which health-care legislative efforts evolved and to examine how one generation's compromises—employment-based insurance in the 1940s—became successive generations’ untouchable special interest. Starr’s standpoint is defined by his service during the Clinton administration. His account builds up to those years, by way of Nixon's efforts for family health insurance, as well as earlier actions, when health-care coverage and costs in the U.S., Britain and Canada were comparable—and therefore quite different from today. The author demonstrates how political bipartisanship in search of practicable solutions, which had been customary prior to Clinton's term, has been undermined, and how redefining health care away from a universal rights–based approach has impacted the policies adopted in both positive and negative ways. A useful contribution as the country moves forward with the implementation of health-care reform.