| Book Review | The Journal of American History, 93.3

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| Book Review | The Journal of American History, 93.3 | The History Cooperative

Book Review

Poor People's Medicine: Medicaid and American Charity Care since 1945. By Jonathan Engel. (Durham: Duke University Press, 2006. xx, 318 pp. Cloth, $79.95, ISBN 0-8223-3683-9. Paper, $22.95, ISBN 0-8223-3695-2.)
This book will provide a pleasant surprise to many scholars. In contrast to the politicized work that often characterizes social welfare and health care history, it is free of ideological cant. Throughout, the author strives to be fair, nuanced, and accurate.	1
Like most historians, Jonathan Engel sees "ambivalence" and incrementalism as keys to unlocking this topic (p. ix). In contrast to the usual approach, however, he duly considers the positive and negative columns of the ledger. While Engel faults the status quo for coverage gaps, he notes that America's poor live today nearly as long as the nonpoor, survive infancy at rates approaching the population at large, and use private physicians and hospitals at least as much as the privately insured do ... the poor are granted access to some of the best hospitals and physicians in the country. (ibid.)	2
Engel starts by describing the state of poor people's medicine prior to the enactment of Medicare and Medicaid in 1965. Beginning in World War II, alternatives such as Blue Cross enabled the middle class to consume lavish high-tech care while the poor and elderly had to settle for the more stripped-down services of municipal and county hospitals.	. . .

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