Jonathan Engel traces the policy debates over healthcare delivery,
and the ways of paying for it, that were conducted during the
second quarter of the twentieth century in the United States.
Examining the views advanced by doctors, including those unallied
with the American Medical Association's position, as well as by
"reformers" -- academics, public health officers, philanthropists,
foundation executives, and independent scholars -- Engel displays
how the discussion involved much more than the legislative efforts
of New Deal Democrats regarding health insurance.
Under discussion were group care, industrial health plans,
nationalized hospitals, and public dispensaries. Engel's attention
to the letters and other writings of key participants in the
debates enriches his account, with the papers of Morris Fishbein,
the president of the AMA, Michael Davis, a researcher for the
Julius Rosenwald Foundation, and I. S. Falk, the research director
for the Social Security Administration, adding concrete detail. His
investigation demonstrates that physicians' reactions to
legislative remedies were not monolithic. It also shows that
foundation leaders were instrumental in enlisting organized labor,
farmers, and liberal legislators in the improvement of the "world's
best" medical care, and that the discussion was more than a debate
between political foes. Participants in the debates discovered no
simple solution to the challenges they explored, however, and their
positions above all foreshadow the debate of succeeding
decades.
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