Doctors and Reformers

Doctors and Reformers: Discussion and Debate over Health Policy, 1925-1950 [Paperback]

Author: Jonathan Engel | Language: English | ISBN: 1570034117 | Format: PDF, EPUB

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Doctors and Reformers: Discussion and Debate over Health Policy, 1925-1950
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Jonathan Engel traces the policy debates over healthcare delivery, and the ways of paying for it, that were conducted during the second quarter of the twentieth century in the United States. Examining the views advanced by doctors, including those unallied with the American Medical Association's position, as well as by "reformers"-academics, public health officers, philanthropists, foundation executives, and independent scholars-Engel displays how the discussion involved much more than the legislative efforts of New Deal Democrats regarding health insurance.

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• Series: Social Problems and Social Issues (Univ of South Carolina)
• Paperback: 442 pages
• Publisher: University of South Carolina Press (March 2002)
• Language: English
• ISBN-10: 1570034117
• ISBN-13: 978-1570034114
• Product Dimensions: 1.2 x 5.8 x 8.8 inches
• Shipping Weight: 1.5 pounds (View shipping rates and policies)
• Amazon Best Sellers Rank: #630,847 in Books (See Top 100 in Books)

This is an extremely well-written and well organized book, with a well chosen period in the history of American healthcare,1925-1950. I find nothing particularly liberal or socialist about it; surely, I must have read a different book than the previous reviewer. Engel's policy focus is below the level of the great leaders of the time such as Roosevelt, but above that of the man on the street. At this level, we get a little of the personal and professional struggles of people who actually created and opposed health care reform proposals such as the AMA's Morris Fishbein and Isadore Falk. We can also gain some understanding of the links between the reformers and the philathopic funds and government agencies that supported them. One interesting story is that of John Kingsbury, the Director of the reform-minded Milbank fund during this period, who was fired by the fund after the AMA threatened to boycott Borden milk, the family business financing the fund. The heterogenous attitudes toward reform that characterized the physician community stemming from the variety of circumstances in which they practiced medicine provides a more nuanced understanding of the AMA membership. Engel paints a picture of the differences in perspective of rich urban specialists versus poor rural generalists, for example. Engel is particularly adept at providing the broader context in which these struggles played out, and describing the varied reactions of reformers to their agonies of defeat. I have to mention that I was very surprised to learn that Harvey Cushing, the famous neurosurgeon, was a member of the Commmittee on Economic Security, and that he had a personal relationship with FDR through his daughter who was married to one of FDR's sons. If you are interested in the history of American health care policy during this period, then you must read this book.

By Amergin

As a timeline and description of events, this book is excellent. Although it misses a few contextual events in the parallel history, I suppose that inclusion of more parallel occurrences would have produced a volume twice the size. The facts and history presented are tarnished by Engel's frequent editorial comments that are inserted here and there. While some of the players in the AMA are made out to be ogers via a carefully placed derogatory word here and there, there seems to be blinders about people like Falk who are spoken of in more dulcid terms. Those who know anything of the history of the period know that the "reformers" in many cases (perhaps with the shap exception of Sydenstricker) were hardly evidence-based policy makers and were clearly driven by the socialist models of Europe. Regardless of Engels unquestionable liberal cum socialist bent, his leanings are only a distraction from an otherwise excellently wrtitten piece.

By Shelby Dunn

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