In the book, One Nation, Insured, Quadagno reveals the shortcomings of the medical care system in the country that is heavily regulated by the legislature thus emphasizing that America is the only country that has serious problems with insurance coverage. The writer also discovers the legal problems where Congress failed to pass the necessary legislation thus forcing the Health insurance companies to report to the government. In addition, Quadagno also expresses her resentment concerning the government’s reluctance to adopt the appropriate health care programs on providing the private and defending the rights of people. Finally, the writer describes the actual situation in the health care sphere. As a sociologist and a former advisor of the president, Jill managed to narrate the stories about the insurance companies and organized doctors protecting their social rights and displaying Clinton’s negligence in improving the health care satiation in the country.
One Nation, Uninsured is a kind of explanation, the narration about the power of the interest group impact on the pluralistic views of the political parties where the privileged status was still occupied by those groups: “stakeholder mobilization [has been] the primary obstacle to the national health insurance”, the writer argues (Quadagno 2006:11). In other words, the professor tries to emphasize the confrontation of the private and public sectors of the country. The authors argue, “the right to health care I recognized in international law and guaranteed in the constitutions of many nations. Except the United States…”(Quadagno, 2006:1) so that book, thus, analyzes the historical conditions that influence the status of the insurance system.
According to Quacagno, “Chapter 1 describes how, from the Progressive Era to 1950, physicians mobilized against proposals for government health insurance.” (Quadagno 2006:16) At the beginning of the twentieth century, there was confrontation socialism presented of the AALL progressive movement. Over time, it was further opposed to the theory of state-socialism that appeared in New York. This movement, headed by Mr. Rooney, opposed the compulsory health insurance where doctors and physicians strived to denounce the reforms and to declare the freedom of choice and life on their land (Quadagno 2006:18).
In this chapter, the author presents four theories, such as socialism, progressivism, exceptionalism, and capitalism. Another theory presented in the paper is the capitalist theory in which the author discloses the emerging confrontation between the capitalist class and the working class because of the care problems. Here, the author can witness the capitalist oppositions represented by the American Medical Associations, though having little influence on the reform introduction and labor movement introduced by the Gompers and AFL affiliates, namely the United Mine Workers and the International Ladies’ Garment Workers’ Union (Quadagno 2006:21). Quadagno also depicts the emergence of the opposite progressive movement defending the rights of the workers and the destructive policy of the government. From the beginning of the book, the writer involves the reader into the political issues of the physicians leading their anti-reform coalitions against the government being afraid that the state could impose an excessive control on the health care institutions thus depriving them of the private profitable market (Quadagno 2006:20). The created American Association for Labor Legislation (AALL) tried to put forward three reforms that were opposed to the League for the Conversation of Public Health. The so-called progressives “formed hundreds of voluntary organizations such as the National Child Labor Committee, the National Consumers League, and Women’s Trade Union League “to root out corruption in government, make cities more livable and improve industrial working conditions” (Quadagno 18). This anti-socialist movement also encouraged the workers by increasing wages and decreasing the employment level. The organized movement aimed at exposing socialism as an effective tool of the capitalist government to abuse the social rights of middle-class workers. Exceptionalism is also the social theory attached to American history revealing the people’s desire to become a unique nation.
“The second chapter investigates why the trade unions helped promote the nascent private health insurance system but also led the drive for disability insurance and Medicare” (Quadagno 2006:16). The writer, here, focuses on the hidden political motives of the private sector they intended to gain from that campaign. As a result, it led to the destruction of the universal coverage because the private sector was not keen on reforming the insurance segment (Quadagno 2006:46).
“Chapter 3 shows how the radical politics the South were played out within the health care system and how the enactment of Medicare provided federal officials with the resources to impose racial integration on southern hospitals” (Quadagno 2006:16). This chapter is especially worthy of attention where the author considers the consequences of the fight for ethnic identity (Quadagno 2006:120).
“Chapter 4 explains how Medicare and Medicaid created uncomfortable inflation in the health care system, triggering the purchase revolt” (Quadagno 2006:16). In that period the country, thus, witnessed the economic and financial crisis, as the opposed parties strive to capture the medical market that stipulated the destruction of the health care system and hampered the introduction of the support.
In the 5th chapter, the writer refers to the “decade-long struggle” of the federal government intending to resolve the insurance problem (Quadagno 2006:16). The passage also enlarges the outcomes of this battle influencing the future of the insurance policy. In addition, the chapter shows what changes the national insurance system in the medical sphere and the way the government failed to establish the alternative insurance health care system (Quadagno 2006:156).
“Chapter 6 explains how the failure of federal cost-containment aroused corporate purchasers to experiment with their tactics for controlling costs, giving way to managed care in the 1990s and triggering warfare between physicians and insurers (Quadagno 2006:16).” This approach to the insurance policy was initially doomed to be a failure, as both the private and public organizations did not care about the welfare of the working class (Qadagno 2006: 220).
“Chapter 7 shows how a coalition of insurance companies, small businesses, and managed-care firms crushed a proposal for home care for the disabled in the 1980s, then launched an attack on President Clinton’s plan on universal healthcare in the 1990s. (Quadagno 2006:16)” The writer ignores Clinton’s failure to promote universal health care thus showing that this event is not unique but one of the links of a long chain of failures in the twentieth century.
“Chapter 8 evaluates alternative explanations of the American case in light of the historical evidence presented and analyzes prospects for health care reform in the 21st century (Quadagno 2006:16)” The reforms adopted in the twentieth-first century, where the present government reaps the fruit of its failed attempts to meet the need of the American citizens.
The main purpose of the book is largely revealed through the writers’ political outlook on the events taking place during the twentieth century. The contradictions between the social classes, the rise of various movements were operated by the interest of the right defense, which is the eternal topic for American history.
Upon evaluating On eNation, Uninsured, the main message of the book lies in the accentuation of the political strategy in terms of establishment of the universal political insurance. The author focuses on the proponents of universal coverage, where a particular interest is attached to the labor movement organizations. Hence, many political movements used doctors to carry out the anti-reform propaganda thus striving to lessen the governmental control of the medical sphere. Quadagno managed to highlight the ideological sight of the struggle, where each movement expressed its strategic identity. However, the proponents of the reform were often shredded and betrayed because from the sociological point of view, Quadagno manages to put forward the political side of the social situation in the United States thus disclosing the socialism within the party system. In that regard, the author highlights the political and legal treatment of public insurance and the way it was accepted by the poor layers of society after its previous imposing by the private sector. The author concentrates on the neutral public image of the American Medical Association in the light of prominent political events, such as elections and the victory of Democrats; and rise of the AFL and CIO streams supporting Medicare and the active strategy directed at the vigorous introduction of the universal health care insurance (Quadagno 2006). n addition, the book does not reveal the outright misunderstanding between the opposing movements; the author uses it as a means to present the insurance evolutionary and revolutionary processes. In this respect, the insurance industry and Blue Cross could not be treated as allies, but the political environment made their relations rather bias and disputable so that it was difficult to ignore such a situation.
It should be pointed out that Quadagno’s account was not aimed at separating the opposing sights of the forces but to show what political and social background served as the platform for this battle. In that regard, this book may be perceived as history but not as social science because much of the book is a dedication to the legitimate issues and their enactment in the society of that time. In addition, the book is unlikely to fully reveal the presented theories into the historical context so that it is hard for the reader to define the core points of the political and social developments (Quadagno 2006).
The author’s thesis could be also analyzed from the financial evolution of the United States. The reason for the medical care emergence was purely based on the necessity to provide some changes. The primary reason, thus, did not lie in the social necessity of the working class but the financial and ideological incentives of the government. In that regard, private insurance began developing in the 30s of the twentieth century, when hospitals were in the desperate search for patients; in 1990, there observes the rise of medical care as the result of the capitalists’ desire to control the expenditures of their employees. As it can be seen, each development serves as an alternative to proposals of the insurance industry that only fostered the government penetration into the medical sphere.
Based on the above, the main strength of the book lies in its historical value; the presented events are closely connected with the important political and cultural evolution of the United States. This work proves that the universal coverage is still politically predetermined, as it is closely connected with the problem of national superiority as well. In other words, the high classes of society strived to dominate and be separated from governmental control. The accessible healthcare forced the politicians to promote universal health care insurance. In this case, the gradual emergence of one campaign after another constitutes the reason for endless chains of crises that are still impossible to stop. Here the reader could find the link between the process of industrialization, the development of capitalist relations, and the social and labor movement for and against the insurance reforms. Consequently, the work is a reliable guide to the battles for the sake of America’s insurance industry.
In conclusion, the book is rather helpful in studying the American history of the healthcare system from the usual retrospective. This rather vivid and realistic narration of the book uncovers the real intentions of both the political system of America and the private establishment. The book helped me to realize that the social aspect served only as of the sheet for the implicit political and financial operations of the opponents. Hence, these battles proved the fact that money and benefits are the major incentives for public and private organizations where the sociological theories were applied as pseudo goals. In that regard, there arises a certain ambiguity about the role of social theories applied in the book. The book is more likely to reveal the political part of history rather than social and historical. Nonetheless, Quadagno’s account is of significant value for the increasing policy history popularity. The book serves as the basis for analyzing the current events connected with the Medicaid system; it also helped to predict the future development in that sphere.
Bibliography
Quadagno, Jill. 2006. “One Nation, Uninsured: Why the U. S. Has No National Health Insurance”. US: Oxford University Press.