Cover image for Toward a healthy society : the morality and politics of American health care reform
Toward a healthy society : the morality and politics of American health care reform
Fisk, Milton.
Personal Author:
Publication Information:
Lawrence, Kan. : University Press of Kansas, [2000]

Physical Description:
viii, 294 pages ; 24 cm
Format :


Call Number
Material Type
Home Location
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RA395.A3 F54 2000 Adult Non-Fiction Non-Fiction Area

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Few issues concern the American public today more than health care. Just ask anyone who has sat for hours in an HMO waiting room or made countless phone calls trying to have a claim settled-or anyone who can't get coverage. But whenever basic reform is proposed the insurance industry opens a massive campaign against it.

Health care today is part of big business, which in defeating the Clinton plan successfully pushed any kind of basic reform off the political agenda. Continuing citizen support for some form of public insurance is, says Milton Fisk, a sign that basic reform is still possible. In his new book, he argues persuasively that basic reform goes beyond a matter of life and death-it's integral to maintaining a society where concern for others holds its own against the market.

Health care, observes Fisk, is not simply an individual responsibility but a public good much like education, and commitment to the social values underlying these public goods is essential to any just society. A healthy society as a value worth pursuing becomes an empty slogan when the poor get inferior health care, when workplaces are dangerous to health, and when a focus on medical treatment leaves out our bodies' environment.

Taking in the broad sweep of social policy in the last half-century, Fisk describes the shift from welfare toward competitiveness as a key factor in the rise of corporate care in the United States. He analyzes the failure of the Clinton health care plan in detail and shows that its commitment to corporate health care was at odds with its reforming intent. He then argues that without national health insurance, needless obstacles will stand in the way of a healthy society. Ideally, the public fund behind this insurance would be derived from a progressive income tax.

Skillfully blending philosophy, economics, and public policy, Fisk's book breaks new ground in political morality and raises important questions about the way people's needs for health care are being defined to satisfy corporate priorities. At a time when so many Americans can barely afford to get sick, no one concerned with this issue can afford to ignore this work of realism and vision.

Author Notes

Milton Fisk is professor emeritus of philosophy at Indiana University.

Reviews 1

Choice Review

Almost everyone seems to be dissatisfied with the current US medical care system, yet attempts to change it are patchy at best, and not effective. Fisk, a philosopher (emer., Indiana Univ.), takes a much broader view of potential health care reform in this profound analysis of medical and health care in the US. The underlying theme--health care as a social good--supports his argument for "accessible, comprehensive, and quality" health care funded by a single payer system. In three major sections, he first outlines the obstacles to health care reform, then the philosophy behind where we should be, and finally how to get there. The author integrates theory from philosophy, ethics, economics, political science, and public health in making his case. He also incorporates the history of health care reform in this country, including a particularly cogent analysis of the failure of the Clinton plan. The book, which should be considered in its entirety rather than as separate chapters, is well written but aimed at a sophisticated reader. It would appeal to a broad-based audience because of its integration of theory from so many academic disciplines. Upper-division undergraduates through professionals. M. A. Thompson; Saint Joseph College

Table of Contents

Political Morality and Public Goods
Prefacep. vii
Introductionp. 1
Part I. Locating Obstacles to Health Care Reformp. 19
1. The Decline of Compassion and Solidarityp. 21
2. The Struggle to Define Patients' Needsp. 43
3. How Corporate Medicine Limits Reformp. 65
Part II. Redirecting Health Care Ethicsp. 87
4. Collective Provision, Markets, and the Public Goodp. 89
5. Just Health Care and the Common Goodp. 111
6. Democracy Versus Corporatist Decision Makingp. 136
Part III. Making the Transition to Reformp. 159
7. Finance and the Origins of Corporate Health Carep. 161
8. Toward a Radical Politics of Reformp. 187
9. The Struggle for a Healthy Society: Business and Medicine Against the Public Goodp. 207
10. Market Failures and Social Values in Health Carep. 232
Notesp. 251
Indexp. 283