One Nation, Uninsured: Why the U.S. Has No National Health Insurance

Every industrial nation in the world guarantees their citizens access to essential health care services--every country, that is, except the United States. Indeed, one in eight Americans--a shocking 43 million people--a majority of them in working families, do not have any health-care insurance. One Nation, Uninsured offers a vividly written, path-breaking history of America's failed efforts to address the health care needs of its citizens. Ranging across the 20th century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. Quadagno describes how in the first half of the twentieth century physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized "grassroots" protests, conspiring with other like-minded groups to defeat reform efforts. Only with Medicare and Medicaid, coverage for the very poor and the old--two groups that private insurers don't want to cover--have we seen any success with government insured health care. Yet even as Medicare succeeded at mid-century and physicians and the AMA receded from the battle's front lines, the insurance industry assumed a leading role against reform.