By relying on private enterprise more than any other developed nation, American health care has all the appearances of free-market in action. And for more than a hundred years, attempts to reform this system (including President Obama's Affordable Care Act) have been met with opposition from parties warning against the stifling effect of government intervention. What these warnings about federal overreach overlook is the fact that the federal government has long been an indispensible player in guiding and supporting the current US health care system. Its role is so pervasive and of such longstanding importance that it is easy to overlook, but it actually created American health care as we know it today. Seminal public programs stand behind every segment of America's massive and hugely profitable health care industry. This is not to deny the instrumental roles of private entrepreneurship and innovation, but rather to describe the foundation on which they rest. The industry's underlying driving force is a massive partnership between the public and private spheres. The partnership is complex, and its effects are not always ideal. But for better or worse, it shapes every aspect of what we in the United States know as health care. Mother of Invention traces the government's role in building four key health care sectors into the financial powerhouses they are today: pharmaceuticals, hospitals, the medical profession, and private insurance. It traces their history, surveys their growth, and highlights some of their greatest success stories, which together reveal the indispensible role of public initiatives in contemporary private health care. Only by understanding what actually drives our system can we appreciate possibilities for meaningful reform or comprehend the true context - historically and politically - of the Obama plan.

Regulation shapes all aspects of America's fragmented health care industry, from the flow of dollars to the communication between physicians and patients. It is the engine that translates public policy into action. While the health and lives of patients, as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. Government agencies at the federal, state, and local levels direct portions of the industry, but hundreds of private organizations do so as well. Some of these overseers compete with one another, some conflict, and others collaborate. Their interaction is as important to the provision of health care as are the laws and rules they implement.
Health Care Regulation in America is a guide to this regulatory maze. It succinctly recaps the past and present conflicts that have guided the oversight of each industry segment over the past hundred years and explains the structure of regulation today. To make the system comprehensible, this book also presents the sweep of regulatory policy in the context of the interests, values, goals, and issues that guide it. Chapters cover the process of regulation and each key area of regulatory focus - professionals, institutions, financing arrangements, drugs and devices, public health, business relationships, and research.
In a uniquely American way, the system thrives on confrontation between competing interests but survives by engendering compromise. Robert Field shows that health care regulation is an inexorable force that nurtures as well as restricts the enterprise of American health care. For the student, practitioner, executive, policy analyst, orconcerned citizen, this book is an invaluable guide to the policy, politics, and practice of an industry that directly touches us all.