Cover

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Title Page, Copyright, Dedication

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pp. i-vi

Contents

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pp. vii-viii

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Acknowledgments

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pp. ix-x

...Like the health care system it describes, this book reflects a tangle of material, intellectual, and political influences. For the book at least, the intervention of these third parties has been most welcome. I can offer only the “UCR” (usual, customary, reasonable) reimbursement of this prefatory note, and the assurance that, however widely the credit is shared, I assume...

Abbreviations

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pp. xi-xvi

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Introduction: Why No National Health Insurance in the United States?

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pp. 1-11

...explanations for the peculiar trajectory of American social policy. At the same time, the explanatory laundry list is profoundly unsatisfying. Historical accounts often have trouble climbing from narrative to explanation; little of the episodic scholarship on the failure of health reform contributes to our larger sense of the American welfare...

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1. The Political Economy of American Health Care: An Overview, 1910–2000

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pp. 12-45

...reformers pressed unsuccessfully for state legislation mandating health insurance for industrial workers. In 1934–35, architects of Social Security toyed with the inclusion of health coverage alongside pension, unemployment, public assistance, and public health programs. In the next decade, New Dealers floated...

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2. Bargaining for Health: Private Health Insurance and Public Policy

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pp. 46-89

...plans, mop up around their edges, and (in the process) stigmatize those they left behind. In turn, private coverage proved inherently fragmentary and discriminatory: it magnified the impact of job segregation by race and gender, perpetuated the ideal of family-wage male employment, and widened disparities in the social wage created by regional wage competition, uneven unionization, and a...

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3. Between Contract and Charity: Health Care and the Dilemmas of Social Insurance

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pp. 90-135

...characteristic of modern liberalism exaggerated in the American setting, has created a two-tracked welfare system in which contractual employment benefits or contributory public programs have always been more important and more legitimate than means-tested charitable assistance. From early in the twentieth century, fascination with contractual benefits imbued social provision with...

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4. Socialized Medicine and Other Afflictions: The Political Culture of the Health Debate

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pp. 136-171

...arguments of their opponents, and set the terms and the boundaries of public discourse. This is not to say, as is often casually concluded, that a popular aversion to statist solutions doomed the prospects for national health insurance. Periodic measures of public support suggest quite the opposite: most Americans did not view...

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5. Health Care in Black and White: Race, Region, and Health Politics

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pp. 172-209

...implications of universal social programs. At the same time, racial distinctions have rarely been explicit, masquerading as anxieties about “Americanization” in the Progressive Era, as administrative distinctions between agricultural and domestic and industrial workers in the New Deal, as deference to private labor markets...

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6. Private Interests and Public Policy: Health Care’s Corporate Compromise

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pp. 210-260

...social democratic tradition and the weakness of state institutions both reflect this pattern of economic influence and contribute to it. The federal system exaggerates the clout of economic interests, which are able to play political jurisdictions off against one another. Over time, the political status of economic interests...

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7. Silenced Majority: American Politics and the Dilemmas of Health Reform

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pp. 261-296

...Although reformers always commanded a clear and substantial majority of public support, they only rarely made themselves heard above the cacophony of the corporate compromise and were quickly silenced when they did. In part this reflected a political system characterized by routine deference to economic...

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Conclusion: The Past and Future of Health Politics

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pp. 297-302

...and those commanded by reformers. Though increasingly at odds over the costs or implications of political solutions, the parties to health care’s corporate compromise have at least shared the ability and the willingness to deflect reformwhenever their stakes in the private health market have been threatened. And...

Archival Sources

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pp. 303-306

Index

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pp. 307-316

Further Reading

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pp. 317-317