cover image One Nation, Uninsured: Why the U.S. Has No National Health Insurance

One Nation, Uninsured: Why the U.S. Has No National Health Insurance

Jill Quadagno. Oxford University Press, USA, $28 (288pp) ISBN 978-0-19-516039-0

According to Quadagno, the short answer to her subtitle is a fairly easy one: America lacks national health insurance because powerful interests have always managed to prevent Congress from passing the necessary legislation. As this slim history shows, however, those interest groups weren't always the obvious suspects. Although Quadagno, a sociologist and former presidential advisor, does write plenty about how organized physicians and insurance companies have lobbied to protect their interests over the last century, showing how the Clintons' disastrous attempt at health care reform is just the tip of the iceberg, she also offers insights into why labor unions rejected government-led solutions to the health care problem to focus on their own collective bargaining efforts. Other chapters detail conservative framing of national health care as ""an insidious communist plot"" and the fight southern doctors raised against the racial integration of medical facilities during the civil rights era. Quadagno unapologetically advocates for the sort of program that the United States has so far failed to adopt, but admits that it will never happen until health care is considered a ""social right, not a consumer product."" Her analysis of the repeated defeats is unlikely to find much traction with anyone besides the hardcore policy wonks, however, as her blow-by-blow accounts of the political battles fail to generate much heat.