Beginnings Count

Book excerpt: This book explores the impact of American values on the evolving design of health care. It gives us a fascinating picture of three machines--the iron lung, the dialysis machine, and the respirator--and three turning points in health policy: the rise of Blue Cross, the passage of Medicare, and the failure of the Clinton Health Security Act. By analyzing the links between medical technologies and legislative developments, this pioneering book clarifies the complex relationship between social values and public policy in the shaping of our health care system. It helps us to understand why middle-class Americans preferred to keep government out of health care, when they made exceptions to the rule, and how their preferences fit with their own experiences and served their self-interest. Beginnings Count argues that it is lived history, not an abstract commitment to marketplace forces or a reflexive opposition to big government, that has shaped the American Way in health care.