Kirjahaku

In the wake of the recent unsuccessful drive for health care reform, many people have been asking themselves what brought about the failure of this as well as past attempts to make health care accessible to all Americans. The author of this original exploration of U.S. health policy supplies an answer that is bound to raise some eyebrows. After a careful analysis of the history and issues of health care, David Rothman concludes that it is the average employed, insured "middle class"--the vaguely defined majority of American citizens--who deny health care to the poor. The author advances his argument through the examination of two distinctive characteristics of American health care and the intricate links between them: the ubiquitous presence of technology in medicine, and the fact that the U.S. lacks a national health insurance program. Technology bears the heaviest responsibility for the costliness of American medicine. Rothman traces the histories of the "iron lung" and kidney dialysis machines in order to provide vivid evidence for his claim that the American middle class is fascinated by technology and is willing to pay the price to see the most recent advances in physics, biology, and biomedical engineering incorporated immediately in medical care. On the other hand, the lack of a universal health insurance program in the U.S. is rooted in the fact that, starting in the 1930's, government health policy has been a reflection of the needs and concerns of the middle class. Playing up to middle class sensibilities, the American presidents, Senate and Congress based their policy upon the private rather than the public sector, whenever possible. They encouraged the purchase of insurance based on the laws of the marketplace, not provided by the government. Private health insurance and high-tech medicine came with a hefty price, with the end result that about 40 million Americans could not afford medical care and were left to fend for themselves. The author investigates the moral values underpinning these decisions, and goes to the bottom of the problem of why the United States remain the only developed country which continually proves unable to provide adequate health care to all its citizens.

The Willowbrook Wars is a dramatic and illuminating account of the effort to close down a scandal-ridden institution and return its 5,400 handicapped residents to communities in New York. The wars began in 1972 with Geraldo Rivera's televised raid on the Willowbrook State School. They continued for three years in a federal courtroom, with civil libertarian lawyers persuading a conservative and conscience-stricken judge to expand the rights of the disabled, and they culminated in a 1975 consent decree, with the state of New York pledging to accomplish the unprecedented assignment in six years.From 1975 to 1982, David and Sheila Rothman observed this remarkable chapter in American reform of mental disabilities care. Would the state live up to its agreement without "dumping" residents into other nightmarish institutions? Would the lawyers prove as interested in meeting client needs as in securing client rights? Could a tradition-bound bureaucracy create a new network of community services? And finally, would a governor and a legislature tolerate such outside intervention, and if so, for how long? In answering these questions,The Willowbrook Wars takes us behind the scenes to clarify the role of the judiciary, the fate of the underprivileged, and the potential for social justice. In their new afterword, the authors bring the story up to date, describing the results of the closing of the institution in 1987 from the experiences of integrating the former residents into communities to the legal battles between the state of New York and advocates for the mentally handicapped.

The Willowbrook Wars is a dramatic and illuminating account of the effort to close down a scandal-ridden institution and return its 5,400 handicapped residents to communities in New York. The wars began in 1972 with Geraldo Rivera's televised raid on the Willowbrook State School. They continued for three years in a federal courtroom, with civil libertarian lawyers persuading a conservative and conscience-stricken judge to expand the rights of the disabled, and they culminated in a 1975 consent decree, with the state of New York pledging to accomplish the unprecedented assignment in six years.From 1975 to 1982, David and Sheila Rothman observed this remarkable chapter in American reform of mental disabilities care. Would the state live up to its agreement without "dumping" residents into other nightmarish institutions? Would the lawyers prove as interested in meeting client needs as in securing client rights? Could a tradition-bound bureaucracy create a new network of community services? And finally, would a governor and a legislature tolerate such outside intervention, and if so, for how long? In answering these questions,The Willowbrook Wars takes us behind the scenes to clarify the role of the judiciary, the fate of the underprivileged, and the potential for social justice. In their new afterword, the authors bring the story up to date, describing the results of the closing of the institution in 1987 from the experiences of integrating the former residents into communities to the legal battles between the state of New York and advocates for the mentally handicapped.