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The Politics of Medicare (Social Institutions and Social Change)

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Title: The Politics of Medicare (Social Institutions and Social Change)
by Theodore R. Marmor
ISBN: 0-202-30425-6
Publisher: Aldine de Gruyter
Pub. Date: 01 January, 2000
Format: Paperback
Volumes: 1
List Price(USD): $17.95
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Average Customer Rating: 5 (4 reviews)

Customer Reviews

Rating: 5
Summary: Master Political Scientist Provides Timely Update
Comment: The first edition of The Politics of Medicare, reprinted in part for the second edition, provides an engaging analytical structure for understanding the complex forces of governments and politics. While studying under the author, a gifted political scientist, years ago, the first edition was a cornerstone in our studies of healthcare politics and programs in the United States. The book equips the reader with the tools and knowledge to understand political forces well beyond the Medicare program.

The analysis of Medicare in the 1990s, found in the current volume, is excellent. This is an ideal time to read or reread the book since Medicare program changes will face our new President and the newly elected or reelected members of our House of Representatives and Senate during 2001. This fall I read the second edition and found the book very informative and enjoyable.

Rating: 5
Summary: One of a Kind
Comment: Have you ever wondered how Medicare-the federal health insurance program for the elderly and some disabled--became such a hot news topic, or why its administration and benefit package (the lack of outpatient drug coverage, for example) seems so inexplicable and byzantine?

If so, Theodore Marmor's reissue and revision of The Politics of Medicare is the book you want to pick up. There is no comparable book of its kind. Other scholars have studied Medicare's origins. Journalists trace the ebb and flow of contemporary Washington battles over Social Security and Medicare. But Marmor, a Yale professor and health policy guru, has written the definitive analysis of how the political battles waged over health insurance and Medicare from the 1940s onward powerfully shape the debate over the program to this day.

Wondering why Medicare, unlike almost all major private insurance plans, fails to cover most prescription drugs? The seeds of an answer may be found in the fears of 1960s legislators that the unpredictable cost of drugs could swamp the program at its outset. Unsure why medical expenditures took off in the 1960s and 1970s? Partly because doctors, who had led the charge against a government-sponsored social insurance program for the aged, benefited enormously from generous rules that were designed to assauge their fears about participation. Puzzled how Medicare became such a political hot potato after years of uninterrupted popularity? Marmor deftly shows how the Reagan administration reoriented widely-held fears about medical inflation into narrower fears about the supposedly unsustainable cost of public programs.

Another reason that this astute volume bears reading, or rereading: Marmor shows that elections can really matter. In the absence of the Democratic majority in Congress that emerged from the 1964 elections, passage of Medicare would have been delayed or forestalled altogether.

Within the cozy world of health policy analysts, Marmor is known for being a staunch proponent of national health insurance and a skeptic about the potential of HMOs and different forms of "managed competition" to control health costs and delivery quality care. His convictions enliven the text rather than detracting from its rigorous logic. This is a book that anyone interested in the politics of health care, and in American politics in general, will appreciate.

One thing alone mars this otherwise impressive book: its packaging. Sadly, any seven-year old with access to Microsoft Excel could have improved on the volume's rudimentary and unappealing charts and graphics. But the reader shouldn't let this superficial flaw detract from Marmor's important and unusually well-written book.

Rating: 5
Summary: A Valuable Update to a Public Policy Classic
Comment: Revised for the first time since 1973, Marmor's *The Politics of Medicare* still stands as the best single book on the political genesis of Medicare. In this valuable new edition, Marmor brings his classic analysis up to date while addressing the arguments of contemporary critics of the program. During an election year in which Medicare looms large, there is no better guide to the political past and future of America's public health insurance program for the elderly and disabled.

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