To the casual observer, a quick look at the American healthcare system brings out more questions than insights. Most of the developed world has some form of socialized medicine, whether nationalized health insurance or a national health system. By comparison, the American system appears disorderly and inefficient, yet resisting any changes, some swear by its effectiveness. Why? The answer lies not in a simple social, political, or economic force but in the scope of history. In this book, originally written in 1982, Paul Starr offers a seminal historical narrative that won the 1984 Pulitzer Prize. These dynamics remained relevant entering the Obamacare debates of the 21st century and continue to influence after that legislation modified the system.
I did not read the updated edition with a new epilogue published in 2017, but I am now curious what the epilogue says. This book clearly has the marks of a text that interested parties need to study for generations. It’s well-researched, eloquent, and with abundant endnotes. If anything, it’s too careful in its treatment and could become difficult and dense to read. Of course, readers who, like myself, appreciate scholarly erudition will appreciate the challenge.
America’s political landscape in the 1980s clearly influences Starr’s perspective. The 1960s offered ambitious scientific progress while the 1970s offered inflationary pressures. The election of 1980 transformed political dynamics by pushing cost controls to the fore. Starr’s final two chapters address these issues squarely to its original audience. However, the preceding nine chapters of history remain relevant and authoritative forty years later.
I slogged through years of medical school and presently work in medical research. Still, Starr taught me tones, and I wish I had read this book before I undertook these ventures. Understanding the social and economic dynamics can help explain human behavior around the biology and medicine. It simply isn’t better expressed than here. Other books offer more recent opinions about how to shape today’s future in 2024, but this history offers a clear explanation of how we got here. Again, reading forty years later, I found little that speaks of cobwebs in an ancient relic. It remains extremely relevant.
Anyone interested in a “big picture” look at the American medical system should start here. Political diatribes – and there are plenty of those – seem to paralyze rather than enhance constructive dialogue. This book, in contrast, informs and educates. Those working in the healthcare system and especially those leading the system can benefit. Those interested in government, politics, and health policy can also learn. I can see why it won a Pulitzer. Despite being rooted in discussions of the times, this book approaches being a timeless classic of a history about American healthcare.
The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry
By Paul Starr
Copyright (c) 1982
Basic Books
ISBN13 9780465079353
Page Count: 514
Genre: American History, Healthcare
Sponsored link to www.amazon.com