Ensuring America's Health

Book excerpt: Ensuring America's Health explains why the US health care system offers world-class medical services to some patients but is also exceedingly costly, with fragmented care, poor distribution, and increasingly bureaucratized processes. Based on exhaustive historical research, this work traces how public and private power merged to favor a distinctive economic model that places insurance companies at the center of the system, where they both finance and oversee medical care. Although the insurance company model was created during the 1930s, it continues to drive health care cost and quality problems today. This wide-ranging work not only evaluates the overarching political and economic framework of the medical system but also provides rich narrative detail, examining the political dramas, corporate maneuverings, and forceful personalities that created American health care as we know it. This book breaks new ground in the fields of health care history, organizational studies, and American political economy.