| Table of Contents |
| | Thematic Table Of Contents | xiv |
| | Preface | xx |
| | Introduction | xxii |
| 1. | Health Care And Medical Practice In The New World, 1600--1800 | 1 |
| | Medical Care In The Early Colonial Settlements | 1 |
| | Quarantines And Other Early Public Health Laws | 3 |
| | State Support For Early Colonial Hospitals | 4 |
| | The Boston Smallpox Epidemic Of 1721 | 5 |
| | An Unregulated Marketplace For Health Care Practitioners | 7 |
| | Charlatans, Quacks, And The Patent Medicine Trade | 9 |
| | Colonial Efforts To Regulate Health Care Services | 10 |
| | Shifting Attitudes About Government's Role In Public Health | 11 |
| | Documents | |
| 1.1. | Virginia Colony Imposes the First Public Health Law in the New World, 1610 | 14 |
| 1.2. | Plymouth Colony Assigns Responsibility for Health Care Expenses, 1642 | 15 |
| 1.3. | Massachusetts Colony Passes an Act of Instruction for Medical Caregivers, 1649 | 16 |
| 1.4. | The First Naval Quarantine Act in British America, 1700 | 17 |
| 1.5. | A Law for Regulating Midwives in New York City, 1716 | 18 |
| 1.6. | Supporting Inoculation in Boston during a Smallpox Epidemic, 1721 | 20 |
| 1.7. | A Prominent Boston Physician Campaigns against Smallpox Inoculations, 1721 | 23 |
| 1.8. | Virginia Regulates the Fees of Physicians and Apothecaries, 1736 | 25 |
| 1.9. | New York City Issues Regulations for "The Practice of Physick and Surgery," 1760 | 27 |
| 1.10. | Virginia Legislators Move to Punish Smallpox Inoculators, 1769 | 28 |
| 1.11. | Benjamin Rush Gives Directions for Preserving the Health of Soldiers, 1777 | 30 |
| 1.12. | Washington Orders Compulsory Smallpox Inoculation of the Continental Army, 1777 | 34 |
| 1.13. | Congress Passes An Act for the Relief of Sick and Disabled Seamen, 1798 | 36 |
| 2. | Health Care And Regulation In Antebellum America, 1800--1860 | 38 |
| | Early Outlines Of A Government-Supported Hospital System Take Shape | 39 |
| | Reforms In The Treatment Of The Mentally Ill | 40 |
| | Compulsory Vaccination And Other Public Health Issues | 42 |
| | The Regular Profession In Disarray | 43 |
| | Alternative Healing Choices In The Marketplace | 44 |
| | Jacksonian Democracy And Health Care | 46 |
| | A Regulatory Regime In Retreat | 47 |
| | Medical School Free-For-All | 48 |
| | Birth Of The American Medical Association | 49 |
| 2.1. | Congress Passes a Federal Vaccination Act, 1813 | 51 |
| 2.2. | State Funding Mechanisms for Charity Hospital in New Orleans, 1814, 1837, 1838 | 52 |
| 2.3. | Samuel Thomson Reflects on His Medical System and Regular Physicians, 1822 | 54 |
| 2.4. | John Gunn Attacks Regular Physicians in Domestic Medicine, 1830 | 57 |
| 2.5. | New York Lawmakers Consider Thomsonian Licensing Petitions, 1841 | 61 |
| 2.6. | John Griscom Urges Sanitary Reforms in New York City, 1845 | 65 |
| 2.7. | Dorothea Dix Lobbies State Legislators for a Hospital for the Insane, 1845 | 69 |
| 2.8. | A Sanitary Commission Complains about the Lack of Public Health Regulation in America, 1848 | 74 |
| 2.9. | United States Begins Federal Inspections of Imported Drugs, 1848 | 77 |
| 2.10. | Lemuel Shattuck Issues Recommendations for New Public Health Regulations, 1850 | 79 |
| 2.11. | New York State Incorporates Its First Homeopathic Medical College, 1860 | 82 |
| 3. | The Professionalization Of American Medicine, 1860-1890 | 84 |
| | The Civil War And Public Health | 84 |
| | Postwar Changes To Public Health | 86 |
| | The Transformation Of Almshouses And Hospitals | 89 |
| | Medical Advances Rescue American Hospitals | 90 |
| | Ongoing Battles Within The Medical Profession | 91 |
| | Medical Education After The Civil War | 92 |
| | States Press For Medical Licensing Regulations | 93 |
| | The Rise And Fall Of The National Board Of Health | 95 |
| 3.1. | The Lincoln Administration Approves the U.S. Sanitary Commission, 1861 | 97 |
| 3.2. | U.S. Sanitary Commission Campaign to Reorganize the Medical Bureau, 1862 | 98 |
| 3.3. | An Assassination Attempt Renews Allopath-Homeopath Hostilities, 1865 | 105 |
| 3.4. | New York Metropolitan Board of Health Issues Its First Annual Report, 1867 | 107 |
| 3.5. | Marine Hospitals Services Act, 1870 | 113 |
| 3.6. | Reform Recommendations for Almshouses in Pennsylvania, 1871 | 114 |
| 3.7. | National Quarantine Act, 1878 | 116 |
| 3.8. | Congress Expands the Powers of the National Board of Health, 1879 | 118 |
| 3.9. | A Boston Medical Journal Mourns the Gains of Women Physicians, 1879 | 121 |
| 3.10. | Louisiana Politics Bedevil Federal Health Inspectors, 1881 | 123 |
| 3.11. | A Commentary on "The Present Condition of National Health Legislation," 1885 | 128 |
| 3.12. | U.S. Supreme Court Affirms State Authority over Medical Licensing, 1888 | 131 |
| 4. | Health Care In The Progressive Era, 1890--1920 | 133 |
| | A Revolution In Public Health Regulation | 133 |
| | Roosevelt Charts A New Course In Public Health Administration | 135 |
| | The Spanish Flu Epidemic Of 1918 | 137 |
| | The Ama Comes Into Its Own | 139 |
| | Regulating The Medical Profession | 140 |
| | Emergence Of The Modern American Hospital | 142 |
| | The Growing Problem Of Health Care Costs | 143 |
| | "The Next Great Step In Social Legislation" | 144 |
| 4.1. | A Wisconsin Physician Urges State Regulation of Medical Practices, 1892 | 148 |
| 4.2. | Political Warfare over Smallpox Treatment in Milwaukee, 1894 | 152 |
| 4.3. | A Famous Health Reformer Endorses State Registration of Nurses, 1903 | 155 |
| 4.4. | Government Guidelines for the Medical Inspection of Immigrants, 1903 | 159 |
| 4.5. | Immigration Restriction League Warns about Dangers to Public Health, 1904 | 161 |
| 4.6. | U.S. Supreme Court Endorses Compulsory Vaccination in Jacobson v. Massachusetts, 1905 | 165 |
| 4.7. | A Muckraker Condemns America's Patent Medicine Industry, 1905 | 171 |
| 4.8. | Flexner Report Demands Reforms of American Medical Education, 1910 | 176 |
| 4.9. | A Senator's Call for a Cabinet-Level Public Health Department, 1910 | 182 |
| 4.10. | Roosevelt's "Bull Moose" Party Calls for Universal Health Insurance, 1912 | 185 |
| 4.11. | Public Health Service Compares Health Insurance in America and Europe, 1913 | 189 |
| 4.12. | A Reformer Makes the Case for National Health Insurance, 1916 | 195 |
| 4.13. | Educating Navy Personnel about a Deadly Influenza Epidemic, 1918 | 201 |
| 4.14. | An Insurance Executive Excoriates Government-Run Health Insurance, 1920 | 203 |
| 4.15. | Progressives Assail Industry-Backed Opponents of Health Insurance Reform, 1920 | 207 |
| 5. | The Struggle Over Health Insurance Between The Wars, 1920--1940 | 214 |
| | An Age Of Medical Marvels And Skyrocketing Medical Expenses | 214 |
| | The Economic Toll Of Sickness | 216 |
| | Management And Worker Health Programs In The Early Depression Years | 217 |
| | Group Health Insurance And The Birth Of Blue Cross | 218 |
| | Debating The Role Of Government In Health Care | 220 |
| | The Committee On The Costs Of Medical Care | 221 |
| | A Political Battle Royal | 223 |
| | Roosevelt And The New Dealers | 224 |
| | A New Deal Push For Health Care Reform | 224 |
| | National Health Insurance And The Committee On Economic Security | 225 |
| | Roosevelt Signs The Social Security Act | 227 |
| | The Growing Governmental Role In Health Care | 228 |
| | Taking Up The Health Insurance Gauntlet Once Again | 230 |
| 5.1. | Defending the Sheppard-Towner Maternity and Infancy Protection Act, 1920 | 233 |
| 5.2. | Principles of the American Birth Control League, 1922 | 239 |
| 5.3. | American Medical Association Formally Repudiates "State Medicine," 1922 | 241 |
| 5.4. | A Call for Expanded State Involvement in All Phases of Health Care, 1926 | 242 |
| 5.5. | Establishment of the First Blue Cross Plans, 1930s | 246 |
| 5.6. | Landmark Report from the Committee on the Costs of Medical Care, 1932 | 248 |
| 5.7. | Minority Report of the Committee on the Costs of Medical Care, 1932 | 253 |
| 5.8. | I.M. Rubinow's Quest for Security, 1934 | 257 |
| 5.9. | Franklin D. Roosevelt Voices Support for National Social Insurance, 1934 | 258 |
| 5.10. | Report of the Committee on Economic Security, 1935 | 262 |
| 5.11. | President Roosevelt Signs the Social Security Act, 1935 | 268 |
| 5.12. | Kansas Governor Landon Vows to Repeal Social Security If Elected President, 1936 | 269 |
| 5.13. | U.S. Public Health Service and the Tuskegee Syphilis Experiment, 1936 | 273 |
| 5.14. | National Cancer Institute Act, 1937 | 274 |
| 5.15. | Food, Drug, and Cosmetic Act, 1938 | 277 |
| 5.16. | Report of the Technical Committee on Medical Care, 1938 | 278 |
| 5.17. | Morris Fishbein Describes Health Insurance as a Threat to the Doctor-Patient Relationship, 1939 | 285 |
| 6. | Partisan Jousting Over Health Care In The Postwar Era, 1940--1960 | 289 |
| | Health Care Politics During Roosevelt's Last Years | 289 |
| | Truman Takes Up The Cause | 292 |
| | Out Of The Ashes | 294 |
| | Health Care Politics And The Cold War | 295 |
| | Health Insurance Comes Of Age | 297 |
| | Mixed Fortunes For Blue Cross | 299 |
| | Insurance Reform Fades As A Political Issue | 300 |
| | Eisenhower Touts "Reinsurance" | 302 |
| | Aid For The Aged: The Forand Bill | 303 |
| 6.1. | A Progressive Call for an Expanded Governmental Role in All Phases of Health, 1943 | 306 |
| 6.2. | California Medical Association Defeats State Health Insurance Legislation, 1945 | 311 |
| 6.3. | Truman Calls for National Health Insurance, 1945 | 316 |
| 6.4. | National Mental Health Act, 1946 | 324 |
| 6.5. | Laying the Groundwork for the Hill-Burton Act, 1946 | 329 |
| 6.6. | Modernizing the Hospitals and Clinics of the Veterans Administration, 1946 | 332 |
| 6.7. | Senator Taft Denounces Compulsory Insurance as Socialized Medicine, 1946 | 334 |
| 6.8. | Truman Again Calls on Congress to Address National "Health Needs," 1949 | 338 |
| 6.9. | Eisenhower Unveils a Health Care "Reinsurance" Proposal, 1954 | 343 |
| 6.10. | Polio Vaccination Assistance Act, 1955 | 346 |
| 6.11. | Big Labor Pushes for Government Health Care for the Elderly, 1959 | 348 |
| 6.12. | Congress Passes the Kerr-Mills Act, 1960 | 352 |
| 7. | Medicare Changes The Health Care Landscape, 1960--1980 | 356 |
| | The Advent Of A Democratic Decade | 356 |
| | A Revolution In Mental Retardation Policy | 357 |
| | Surveying The Health Care Landscape | 358 |
| | Kennedy's Campaign For Medicare | 359 |
| | 1964 Election Results Seen As Mandate | 361 |
| | Passing Medicare And Medicaid | 362 |
| | Mixed Results Bring New Controversies | 364 |
| | A Health Care System In Transition | 365 |
| | Nixon's Prescription For America's Health Care "Crisis" | 367 |
| | A Democratic Political Calculation Goes Awry | 369 |
| 7.1. | Ronald Reagan Urges Opposition to Medicare, 1961 | 373 |
| 7.2. | President Kennedy Tries to Rally Public Support for Medicare, 1962 | 377 |
| 7.3. | A Cartoonist Lampoons the American Medical Association, 1962 | 381 |
| 7.4. | Kennedy's Presidential Panel on Mental Retardation, 1962 | 382 |
| 7.5. | American Courts Order Desegregation of Southern Hospitals, 1963 | 387 |
| 7.6. | U.S. Surgeon General's Report on Smoking and Health, 1964 | 390 |
| 7.7. | 1964 Elections Break the Political Logjam on Medicare, 1965 | 393 |
| 7.8. | President Johnson Reflects on His Support for Medicare and Social Security, 1965 | 396 |
| 7.9. | An Influential Member of Congress Recalls the Development of Medicare Part B, 1965 | 397 |
| 7.10. | President Johnson Signs Medicare and Medicaid into Law, 1965 | 400 |
| 7.11. | Launching the War on Cancer, 1969 | 403 |
| 7.12. | A Warning about America's Growing "Medical-Industrial Complex," 1970 | 406 |
| 7.13. | President Nixon Signs the Clean Air Act, 1970 | 411 |
| 7.14. | Justice Blackmun Delivers the Supreme Court Decision in Roe v. Wade, 1973 | 413 |
| 7.15. | Congress Passes the Rehabilitation Act, 1973 | 419 |
| 7.16. | President Nixon Signs the Health Maintenance Organization Act, 1973 | 421 |
| 7.17. | President Nixon Proposes a National Health Insurance Plan, 1974 | 422 |
| 7.18. | President Ford Signs the Employee Retirement Income Security Act, 1974 | 430 |
| 8. | Restraining Health Care Costs In The Age Of Reagan, 1980--1990 | 433 |
| | Sensible Deficit Reduction Or "Shifting The Shaft"? | 433 |
| | Political Battles Over Medicaid's Future | 435 |
| | The Advent Of Medicare's Prospective Payment System | 436 |
| | Debating The Impact Of Pps | 438 |
| | Tackling Medicare Physician Spending | 439 |
| | Iimos Remake The Health Care Landscape | 439 |
| | Patient Care In The Age Of Free Market Medicine | 441 |
| | New Policy Prescriptions For The Pharmaceutical Industry | 442 |
| | Lawyers And Doctors Face Off Over Medical Malpractice | 442 |
| | The Aids Epidemic | 444 |
| | Political Wrangling Over Women's Health Research | 445 |
| | The Americans With Disabilities Act | 447 |
| | Rising Costs Fuel Drive To Identify Best Practices | 449 |
| | The Catastrophic Coverage Debacle | 450 |
| 8.1. | An Investor's Guide to Health Maintenance Organizations, 1982 | 454 |
| 8.2. | President Reagan Signs the Orphan Drug Act, 1983 | 459 |
| 8.3. | Arrival of the Medicare Prospective Payment System, 1983 | 460 |
| 8.4. | Senator Hatch Recalls the Political Battle over the Hatch-Waxman Act, 1984 | 468 |
| 8.5. | Congress Passes the National Organ Transplant Act, 1984 | 473 |
| 8.6. | Women's Health Emerges as a Political Issue, 1985 | 476 |
| 8.7. | COBRA Allows Laid-Off Workers to Keep Their Health Coverage, 1985 | 480 |
| 8.8. | AMA Calls for Relief from Medical Malpractice Lawsuits, 1986 | 484 |
| 8.9. | ABA Defends Medical Malpractice Laws in America's Tort System, 1986 | 489 |
| 8.10. | Reagan's First Major Speech on AIDS, 1987 | 494 |
| 8.11. | HHS Secretary Bowen Recalls the Creation of the Medicare Catastrophic Coverage Act, 1986--1988 | 498 |
| 8.12. | Reagan Signs the Medicare Catastrophic Coverage Act, 1988 | 504 |
| 8.13. | Congress Repeals the Medicare Catastrophic Coverage Act, 1989 | 506 |
| 8.14. | Congress Agrees to Research Best Practices in Health Care, 1989 | 509 |
| 8.15. | Congress Throws Its Support behind the Ryan White CARE Act, 1990 | 511 |
| 8.16. | Government Report Takes the NIH to Task on Women's Health, 1990 | 514 |
| 8.17. | Justin Dart Hails the Signing of the Americans with Disabilities Act, 1990 | 519 |
| 9. | The Clinton Health Plan And Scorched-Earth Politics, 1990--2000 | 522 |
| | Upset Victory In Pennsylvania Seen As Political Bellwether | 522 |
| | Clinton Promises Sweeping Health Care Reform | 523 |
| | Pushing Through Mounting Political Turbulence On Health Care Reform | 524 |
| | Republicans Unite Against The Health Security Act | 526 |
| | Republican Charges Against Health Care Reform Gain Traction | 527 |
| | American News Media And The Health Security Act | 529 |
| | Clinton's Health Reform Plan Goes Down To Defeat | 529 |
| | States Move To Impose New Rules On Hmos | 530 |
| | Clinton Vetoes Gop Medicare And Medicaid Reform Proposals | 532 |
| | Reaching Across The Political Divide | 534 |
| | Historic Tobacco Settlement Brings New Controversies | 536 |
| 9.1. | Harris Wofford Rides Health Care to a Stunning Political Upset, 1991 | 539 |
| 9.2. | Clinton Unveils His Health Care Plan to Congress, 1993 | 541 |
| 9.3. | Hillary Rodham Clinton Testifies in Support of Health Care Reform, 1993 | 548 |
| 9.4. | A Key Strategist Urges Republicans to Defeat Clinton's Health Reform Proposal, 1993 | 552 |
| 9.5. | Senator Dole Lambastes the Clinton Health Care Plan, 1994 | 557 |
| 9.6. | A Democratic Senator Laments the Death of the Clinton Health Reform Plan, 1994 | 559 |
| 9.7. | A Republican Senator Applauds the Demise of the Clinton Health Care Plan, 1994 | 562 |
| 9.8. | Senator Mitchell Closes the Book on the Clinton Health Care Plan, 1994 | 565 |
| 9.9. | Appropriations Battles over Health Care Research, 1995 | 567 |
| 9.10. | President Clinton Vetoes Cuts to Medicare and Medicaid, 1995 | 571 |
| 9.11. | Senator Kassebaum Touts the Health Insurance Portability and Accountability Act, 1996 | 573 |
| 9.12. | Senator Kennedy Urges Passage of Health Insurance Legislation for Children, 1997 | 576 |
| 9.13. | Tobacco Master Settlement Agreement, 1998 | 579 |
| 9.14. | States Take Aim at Managed Care with New Consumer Protections, 1993--1997 | 584 |
| 9.15. | Debating Oregon's Death with Dignity Law, 1997 | 585 |
| 9.16. | Institute of Medicine Sounds an Alarm about Medical Errors in Hospitals, 1999 | 591 |
| 9.17. | President Clinton Extols New Rules to Ensure Medical Privacy, 2000 | 595 |
| 9.18. | RU486 Abortion Pill Adds Fuel to America's Political "Culture Wars," 2000 | 597 |
| 10. | Controversial Policy Prescriptions For American Health Care, 2000--2010 | 602 |
| | George W. Bush Touts Pro-Life Policies | 602 |
| | Controversy Rages Over The Medicare Modernization Act | 604 |
| | The Pros And Cons Of Medicare Advantage | 605 |
| | Making Sense Of The Medicare Prescription Drug Benefit | 606 |
| | Political Brawl Over Schip Obscures Areas Of Consensus | 608 |
| | Heightened Calls For Sweeping Health Care Reform | 609 |
| | Targeting Waste And Inefficiency In The Health Care System | 610 |
| | Policy Prescriptions For Addressing The Health Care Crisis | 612 |
| | Obama Lays Out His Plan For Passing Health Care Reform | 615 |
| | Looking To The Example Of Massachusetts | 616 |
| | Health Reform Hits Tea Party Turbulence | 617 |
| | Democrats Push Toward The Finish Line On Health Care | 619 |
| | Scott Brown's Victory Changes The Political Landscape | 622 |
| | The Democrats Finally Pass Health Care Reform | 623 |
| | Democrats Celebrate, Republicans Vow To Repeal | 625 |
| 10.1. | President Bush Stakes Out His Position on Stem Cell Research, 2001 | 628 |
| 10.2. | Controversial Vote on the Medicare Prescription Drug Act, 2003 | 632 |
| 10.3. | Bush Touts the Medicare Prescription Drug Benefit, 2005 | 638 |
| 10.4. | Massachusetts Passes Major Health Insurance Reform, 2006 | 642 |
| 10.5. | Washington Reacts to a Supreme Court Decision on "Partial-Birth" Abortion, 2007 | 644 |
| 10.6. | Political Battle over SCHIP Reauthorization, 2007 | 647 |
| 10.7. | Bipartisan Support for the Wellstone Mental Health Parity Act, 2008 | 652 |
| 10.8. | White House Forum on Health Reform, 2009 | 655 |
| 10.9. | Major Stakeholders Signal Support for Obama's Health Reform Efforts, 2009 | 658 |
| 10.10. | An Obama Budget Official Defends Health Reform, 2009 | 660 |
| 10.11. | Senator Lieberman Turns against the Public Option, 2009 | 663 |
| 10.12. | Scott Brown's Victory Speech in Massachusetts, 2010 | 666 |
| 10.13. | President Obama and Senator Kyl Square Off at the Health Care Summit, 2010 | 669 |
| 10.14. | Obama Speaks to House Democrats on the Eve of the Health Reform Vote, 2010 | 672 |
| 10.15. | Minority Leader Boehner Urges a Vote against the Affordable Care Act, 2010 | 677 |
| 10.16. | A Republican Pundit Laments a Conservative "Waterloo," 2010 | 679 |
| 10.17. | Obama Signs the Health Care Reform Bill into Law, 2010 | 682 |
| | Chronology | 685 |
| | Bibliography | 689 |
| | Illustration Credit | 693 |
| | Index | 695 |
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