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REVIEWS
| Health Security for All: Dreams of Universal Health Care in America. By Alan Derickson. (Baltimore: Johns Hopkins University Press, 2005. xii plus 240 pages. $30.00).
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| Why is there no national health insurance in the United States? The answer is that there is national health insurance in the United States and quite a lot of it. The problem lies in the fact that this country has too much health insurance—making our health care system very costly—and too little—limiting access to health care to well over forty million people. Alan Derickson, one of this country's best historians of health care policy, asks the right question in this expert monograph on the idea of access to universal health care in America during the twentieth century. He shows that, although the nation has made periodic surges toward national health insurance, the result has never amounted to universal access. In fact, we have moved further away from this ideal in the last third of the last century. |
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Derickson surveys the twisting fortunes of the idea of universal health care through time. In the progressive era, labor economists and others with an interest in the terms of the wage bargain tended to dominate the discussion. The result was proposals from groups such as the American Association for Labor Legislation to have the state subsidize health insurance for the working classes. This class-specific formulation of the problem rankled many Americans, including conservative businessmen and upwardly mobile members of labor unions. Derickson perceptively notes that the progressives imported many of their ideas from abroad. At the time, the European welfare state was far from universal in its scope of coverage. Instead it used the state to confer benefits on particular occupational groups. |
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