Government and Public Health in America

How involved should the government be in American healthcare? Ronald Hamowy argues that to answer this pressing question, we must understand the genesis of the five main federal agencies charged with responsibility for our health: the Public Health Service, the Food and Drug Administration, the Veterans Administration, the National Institutes of Health, and Medicare. In examining these, he traces the growth of federal influence from its tentative beginnings in 1798 through the ambitious infrastructures of today - and offers startling insights on the current debate.

The author contends that until the twentieth century, governmental involvement in health care policy was nominal. With the sweeping food and drug reforms of 1906 and the Medicare amendments to Social Security in 1965, a whole new system of health care was brought to the American public. A careful analysis of the various programs generated by this legislation, however, shows a different picture of pet projects, budgetary lobbying, competitive bureaucracy and discord between the agencies and their opposition. Government and Public Health in America provides an illuminating look at the complicated forces that created these institutions and provokes discussion about their usefulness in the future.

Hamowy's thoroughly researched analysis fills a substantial gap in the history of health policy. Economists, political scientists, historians, sociologists and health professionals concerned with the interface between government and health care will find much to recommend in this highly readable account of a fascinating topic.