Patients as Policy Actors offers groundbreaking accounts of one of the health field's most important developments of the last fifty years--the rise of more consciously patient-centered care and policymaking. The authors in this volume illustrate, from multiple disciplinary perspectives, the unexpected ways that patients can matter as both agents and objects of health care policy yet nonetheless too often remain silent, silenced, misrepresented, or ignored. The volume concludes with a unique epilogue outlining principles for more effectively integrating patient perspectives into a pluralistic conception of policy-making. With the recent enactment of the Patient Protection and Affordable Care Act, patients' and consumers' roles in American health care require more than ever the careful analysis and attention exemplified by this innovative volume.

The Clinton administration's failed health care reform was not the first attempt to establish government-sponsored medical coverage in the United States. From 1915 to 1920, Progressive reformers led a spirited but ultimately unsuccessful crusade for compulsory health insurance in New York State. Beatrix Hoffman argues that this first health insurance campaign was a crucial moment in the creation of the American welfare state and health care system. Its defeat, she says, gave rise to an uneven and inegalitarian system of medical coverage and helped shape the limits of American social policy for the rest of the century. Hoffman examines each of the major combatants in the battle over compulsory health insurance. While physicians, employers, the insurance industry, and conservative politicians forged a uniquely powerful coalition in opposition to health insurance proposals, she shows, reformers' potential allies within women's organizations and the labor movement were bitterly divided. Against the backdrop of World War I and the Red Scare, opponents of reform denounced government-sponsored health insurance as ""un-American"" and, in the process, helped fashion a political culture that resists proposals for universal health care and a comprehensive welfare state even today. |Shows how the issues that prevented passage of the 1915-1920 campaign for compulsory health insurance in New York helped to shape a national political culture that continues to resist proposals for universal health care as ""un-American.

The 2010 Affordable Care Act (or Obamacare, as its detractors like to call it) is a sweeping reform to the US health care system. Despite the fact that nearly every other developed country in the world considers health care a right, the passage of the act in the United States was hard fought, due to a staunch and vocal opposition to universal health care among many American lawmakers. Why has the United States been so continually divided on this issue? In "Health Care for Some", Beatrix Hoffman offers an explanation in the form of an engaging and in-depth look at America's long tradition of unequal access to health care. Hoffman argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American type of rationing. "Health Care for Some" shows that the haphazard way the US system allocates medical services - using income, race, region, insurance coverage, and many other factors - is a disorganized, illogical, and powerful form of rationing. And unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world. While most histories of US health care emphasize failed policy reforms, "Health Care for Some" looks at the system from the ground up in order to examine how rationing is experienced by ordinary Americans - from soldiers' pregnant wives to survivors of Hurricane Katrina - and consequently reveals how experiences of rationing have led to claims for a right to health care. The story of the Affordable Care Act is still being written, and its ultimate success or failure has yet to be determined. To understand how we got here and what might be to come, you could have no better primer than "Health Care for Some".

In Health Care for Some, Beatrix Hoffman offers an engaging and in-depth look at America's long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American approach to the rationing of care. Health Care for Some shows that the haphazard way the US system allocates medical services - using income, race, region, insurance coverage, and many other factors - is a disorganized, illogical, and powerful form of rationing. And unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world. While most histories of US health care emphasize failed policy reforms, Health Care for Some looks at the system from the ground up in order to examine how rationing is experienced by ordinary Americans and how experiences of rationing have led to claims for a right to health care. By taking this approach, Hoffman puts a much-needed human face on a topic that is too often dominated by talking heads.

Patients as Policy Actors offers groundbreaking accounts of one of the health field's most important developments of the last fifty years--the rise of more consciously patient-centred care and policymaking. The authors in this volume illustrate, from multiple disciplinary perspectives, the unexpected ways that patients can matter as both agents and objects of health care policy yet nonetheless too often remain silent, silenced, misrepresented, or ignored. The volume concludes with a unique epilogue outlining principles for more effectively integrating patient perspectives into a pluralistic conception of policy-making. With the recent enactment of the Patient Protection and Affordable Care Act, patients' and consumers' roles in American health care require more than ever the careful analysis and attention exemplified by this innovative volume.