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Beginnings Count - The Technological Imperative in American Health Care. A Twentieth Century Fund Book (Hardcover, New)
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Beginnings Count - The Technological Imperative in American Health Care. A Twentieth Century Fund Book (Hardcover, New)
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In the wake of the recent unsuccessful drive for health care
reform, many people have been asking themselves what brought about
the failure of this as well as past attempts to make health care
accessible to all Americans. The author of this original
exploration of U.S. health policy supplies an answer that is bound
to raise some eyebrows. After a careful analysis of the history and
issues of health care, David Rothman concludes that it is the
average employed, insured "middle class"--the vaguely defined
majority of American citizens--who deny health care to the
poor.
The author advances his argument through the examination of two
distinctive characteristics of American health care and the
intricate links between them: the ubiquitous presence of technology
in medicine, and the fact that the U.S. lacks a national health
insurance program. Technology bears the heaviest responsibility for
the costliness of American medicine. Rothman traces the histories
of the "iron lung" and kidney dialysis machines in order to provide
vivid evidence for his claim that the American middle class is
fascinated by technology and is willing to pay the price to see the
most recent advances in physics, biology, and biomedical
engineering incorporated immediately in medical care. On the other
hand, the lack of a universal health insurance program in the U.S.
is rooted in the fact that, starting in the 1930s, government
health policy has been a reflection of the needs and concerns of
the middle class. Playing up to middle class sensibilities, the
American presidents, Senate and Congress based their policy upon
the private rather than the public sector, whenever possible. They
encouraged the purchase ofinsurance based on the laws of the
marketplace, not provided by the government. Private health
insurance and high-tech medicine came with a hefty price, with the
end result that about 40 million Americans could not afford medical
care and were left to fend for themselves. The author investigates
the moral values underpinning these decisions, and goes to the
bottom of the problem of why the United States remain the only
developed country which continually proves unable to provide
adequate health care to all its citizens.
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