The Health Care Mess: How We Got Into It and How We’ll Get Out of It
by
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In the summer of 1986, John Musick, my boss at Minnesota COACT (Citizen Organizations Acting Together), asked me if I would like to direct a citizen campaign for universal health insurance. At that time, I knew almost nothing about health policy. I couldn’t have told you how much the
Despite my gross ignorance of health policy, my gut reaction to John’s question was excitement. It excited me to think about building an army of people to take on the insurance industry and the AMA. The unaffordability of health insurance and medical care affected all Americans – deeply and personally. It would be three more years before the media began talking about the “health-care crisis,” but the staff and members of COACT were already well aware that a crisis was upon us. So too, it turned out, were citizen groups around the country.
COACT’s leaders and staff were aware of the problem because we had been organizing low- and middle-income Minnesotans on a variety of economic issues since COACT’s formation in
I had no doubt, then, that a campaign to make health insurance available to all Americans would excite COACT’s membership and staff and help us attract even more members. But my excitement at John’s question was tempered by what I perceived to be two big obstacles to a successful people’s campaign to establish universal insurance in this country.
The first obstacle was the power of our opponents. I did not know at the time that the U.S. health-care system absorbed almost one-eighth of every dollar Americans earn (today we spend almost one-sixth of our income on health care), but I knew the players in that industry, including the insurers, the doctors, the hospitals, and the drug industry, had a lot of money and political power and would use it against any proposal they saw as a threat to their welfare. I assumed that it would take an unusually strong movement – something at least as strong as the civil rights and anti-war movements of the sixties – to beat these guys. Even though COACT represented 20,000 Minnesotans and had an annual budget of about $700,000, we were minnows compared to the whales that dominated the health-care industry.
The second problem I perceived was the complexity of the
Despite my concern about the complexity of health policy and the power of our opponents, I told John I would be happy to direct a campaign for universal coverage if the COACT board decided we should undertake it. John agreed that the opposition would be intense and that we would have to work in coalition with other organizations.
Things moved very quickly after that conversation. COACT’s board endorsed the health-care campaign that fall, and, in November 1986, officers of Minnesota COACT and the Minnesota Senior Federation (another citizen group representing
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About the Book
The rapid deterioration of the American health-care system, and the debate about what to do about it, is generating a maelstrom of news stories, magazine articles, and books. But the average person finds it difficult to make sense of this blizzard of information. Because the health-care system is large and complex, and because the symptoms of its decline are numerous, comprehensive reports about the health-care crisis are extremely rare. Comprehensive reports in everyday language are nonexistent.
The Health-Care Mess was written to fill that void. It assumes the reader knows nothing about health policy. As Kip Sullivan puts it, The Health-Care Mess is the book he wishes someone had given to him in 1986 when he, a community organizer, jumped into the cold, choppy waters of the health-care reform debate. At that time, he had no training in health policy. But in the course of studying the health-care system and explaining its problems to thousands of people, he discovered that health policy is not only accessible but fascinating.
The book resembles a textbook in that it treats a complex subject comprehensively, and it is meticulously documented. But it doesn’t read like a textbook. The author speaks in an informal, conversational style, he makes minimal use of jargon, and explains what jargon he has to use. And he is not coy about expressing his opinions. He believes the health-care reform debate has been unduly influenced by big corporations, especially those in the insurance and drug industries. He concludes that the health-care crisis will be solved only when
The Health-Care Mess explains the debate about what’s wrong with the health-care system, and how to fix it, in terms everyone can understand.
About the Author
Kip Sullivan has been teaching and writing about the American health-care crisis since 1986. His articles on this subject, which now number over 100, have appeared in the New York Times, the Los Angeles Times, The Nation, the Washington Monthly, the New England Journal of Medicine, and Health Affairs.
Mr. Sullivan is a graduate of
Mr. Sullivan’s background makes him unique among those who write about health policy. Unlike most health-policy experts, he has had to explain health policy to everyday people as opposed to other health-policy experts or students interested in becoming health-policy experts. Unlike most health-policy experts, Mr. Sullivan has no financial connection to the health-care industry. He has been completely free to seek a solution to the health-care crisis that will benefit the average person as opposed to health insurance companies, pharmaceutical manufacturers, and other powerful interest groups that dominate the debate about how to solve the health-care mess.