Saturday, November 12, 2011

Health Reform Remedy and Reaction

Force is not a remedy.

John Bright (1811-1889)

November 12, 2011 - I note with pleasure that the Yale University Press has released Paul Starr’s new book, Remedy and Reaction: The Peculiar American Struggle over Health Care Reform, available at $17.35 on Amazon. For that price it’s a steal.

If you’re going to read one book on the ideological chasm over health refvorm between liberals and conservatives, this is the book. Paul Starr is one of the few liberal wonks who fully understands the conservative world view of health care and the dynamics behind the rise of profit and entrepreneurial health care.

He first articulated this understanding in his 1982 book The Social Transformation of American Medicine; The Rise of a Sovereign Profession and the Making of a Vast Industry, Basic Books.

I used this quote from his 1982 book to introduce my 1988 Book, And Who Shall Care for the Sick (Media Medicus,Minneapolis),

In the twentieth century, medicine has been the heroic exception that sustained the waning tradition of independent professionalism. Physicians not only escaped from corporate and bureaucratic control in their own practices; they channeled the development of hospitals, health insurance, and other medical institutions intoforms that did not intrude upon their autonomy. But that except now be brought into line;the great irony is that the opposition of the doctors and hospitals set in action entrpreeurial forces that may end up depriving both private doctors and local voluntary hospitals of their traditional autonomy.

Well said.

Those forces culminated in the health reform law, The Patient Protection and Affordability Care Act, which the Democrats passed in the face of unanimous Republican opposition on March 23, 2011. Ironically, this law, which so far neither protects patients nor makes care more affordable, could be the undoing of President Obama in the November 12, 2012 elections.

Paul Starr, professor of sociology and public affairs at Princeton, co-founder and co-editor of The American Prospect, and chief spokesman for the failed Clinton reform effort in 1994, is a veteran observer of national political wrangles over health reform and of the widely different world views of liberal and conservatives. One view focuses on centralized government control and the other on decentralized market forces.

Rather than give my own views, which I have outlined in my book The Health Reform Maze: A Blueprint for Physician Practices (Greenbranch Publishing) and in 2015 Medinnovation blogs, which bear the slogan, “Where health reform, medical innovation, and physician practices meet,” I shall reprint the Yale University Press’s review of his book, which is accurate and balanced.

"In no other country has health care served as such a volatile flashpoint of ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues.

Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change.

He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990s—and of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt Romney’s reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continues—a penetrating account of how health care became such treacherous terrain in American politics. “

Unfortunately, Democrats, with an eye on their historical legacy, sought to force their health reform remedy through without thoughtful debate and consideration of the consequences.

Paul Starr’s new book, Remedy and Reaction: The Peculiar American Struggle over Health Reform, is a must read (see

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