| Book Review | The Journal of American History, 93.4

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| Book Review | The Journal of American History, 93.4 | The History Cooperative

Book Review

Chronic Politics: Health Care Security from fdr to George W. Bush. By Philip J. Funigiello. (Lawrence: University Press of Kansas, 2005. xii, 395 pp. $39.95, ISBN 0-7006-1399-4.)
"Health security," an idea invoked by leaders, analysts, and agitators for over seven decades, is as chimerical as ever in the first decade of the twenty-first century. One in six Americans has no health insurance, and middle- class families with "good" insurance coverage through employers must pay thousands of dollars in premiums and out-of-pocket expenses annually. Philip J. Funigiello, a professor emeritus of history at the College of William and Mary, follows a number of other scholars in trying to chronicle and explain how our political system produced our contemporary health care system.	1
Funigiello's study focuses on decision making in the federal government and moves fairly seamlessly from one presidential administration to the next. That approach is at once inclusive and exclusive of many key actors and events. On the one hand, it helps readers understand the continuity of issues and policies across time, including periods when there was little or no significant policy development due to insufficient mobilization, unmovable leadership, shifts in strategy, or distractions from external events. On the other hand, it misses the sources of many crucial changes in the health insurance system by omitting or underemphasizing decisions made in other venues, including in tax policy, in state government, and, most importantly, in the private sector.	. . .

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