Cover

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Half title, Title Page, Copyright, Quotation

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pp. 4-7

Table of Contents

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pp. vi-vii

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Preface

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pp. ix-xii

Medicare is a vibrant half century old. None now attacking the Affordable Care Act’s more conservative approach to expanding access to health insurance dare voice similar objections to this far more ambitious and popular one. It’s an anachronism. How did it happen? ...

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1. Formative Years

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pp. 1-26

The patterns of medical practice and its financing in the United States developed between 1894 and 1954. Scientific advances, interest group clashes over power, and underlying social attitudes about race and class shaped its development. Just as early childhood experiences shape a person, so these early years shaped most of what continues to be distinctive about the American health care system. ...

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2. Backbone

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pp. 27-62

Most people don’t have the backbone to be rebels. The risks are too great and the price too high. Only a small minority became civil rights activists during the height of the civil rights struggle. So it was with the American Revolution, the resistance in Nazi-occupied Europe, opposition in Stalinist Russia, and the anti-Apartheid struggle in South Africa. ...

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3. Better Part of Valor

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pp. 63-100

Kennedy’s telegram to Cobb marked a watershed event. However reluctantly, based on their cold calculations of what was politically possible, Presidents Kennedy and then Johnson would follow the lead of the medical activists. Step by step, the activists drew them into using the untested power of federal dollars to force radical change in some of the most powerful institutions in the country. ...

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4. "Children's Crusade"

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pp. 101-140

Gardner’s December 14, 1965, memo must have reached many desks in the HEW bureaucracy with people shaking their heads and muttering, “Is this guy really serious? He can’t possibly mean what I think he means!” Even today, it’s hard to understand all of what Gardner was really thinking. ...

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5. Casualties

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pp. 141-174

Health care’s struggle blended into all the other parts of the larger civil rights struggle. It didn’t end with Medicare’s triumphal children’s crusade any more than the triumphal march from Selma to Montgomery ended the struggle for voting rights. It continued, contested each step of the way, burdened by the loss of the broader optimism that had energized the earlier days of the movement. ...

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6. Seen the Glory

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pp. 175-198

Buried beneath all the events that captured the headlines and television news footage, the civil rights movement quietly attended to the birth of Medicare. The movement changed health care more than any other aspect of American life. It transformed the nation’s most racially and economically segregated institutions into its most integrated. ...

Notes

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pp. 199-210

Bibliography

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pp. 211-226

Index

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pp. 227-238