Michael GusmanoFebruary 13, 2012 - 11:53am0 comments
Remedy and Reaction
The Peculiar American Struggle over Health Care Reform
Yale University Press, $28.50, 336 pp.
In the century prior to the passage of the Patient Protection and Affordable Care Act (PPACA) in 2010, the United States had repeatedly tried—and failed—to adopt comprehensive health-care reform. Although the new law falls short of offering universal coverage, the PPACA represents a remarkable political achievement long viewed by many as impossible. And yet its future is in jeopardy. The Supreme Court has agreed to hear a challenge to the law, and the outcome of that review, expected in June 2012, is uncertain. And since the most controversial provisions—such as expanding the Medicaid program and requiring individuals to purchase health insurance while offering subsidies to people with lower incomes—are not scheduled to be implemented until 2014, the 2012 election could also result in a repeal of the law or an elimination of its funding. Are we looking at a breakthrough, or a continued impasse? Why are we so confused when it comes to changing our health-care system?
In Remedy and Reaction, Princeton sociologist Paul Starr argues that the special nature of our political institutions and culture has combined with a lack of effective leadership and a legacy of divisive policy decisions to shape what he calls the “peculiar American struggle” with health-care reform. In Starr’s view, these factors account not only for the longstanding difficulty of adopting reform, but also for the features of the PPACA that...