Wednesday, January 7, 2015

The Social Transformation of American Medicine by Paul Starr (1982)

Should be required reading for all student physicians. Absolutely brilliant historical account of the beginnings of the profession and industry of healthcare in the United States.

Key ideas outlined in Starr's chapter titles and subtitles that I might be able to describe to you if you asked include;

  • professional sovereignty
    • the market and professional autonomy
    • legitimate complexity
    • origins of medical sectarianism
      • explained origin of homeopathy, eclectics, and orthodox
  • reconstitution of the hospital
    • Hill Burton Act
  • public health vs private practice
  • capitalism and the doctors
    • professional resistance to corporate control
  • the struggle for healthcare reform
    • why America lagged
    • The New Deal
    • Socialized medicine and the Cold War
  • health insurance origins
    • the birth of the blues
    • private social security
  • focus on research
    • how the medical center gained power
  • 1970-1974
    • contradictions of accommodation
    • generalization of rights
    • conservative assimilation of reform
  • 1975-1980
    • generalization of doubt
    • liberal impasse
  • The coming of the corporation
And that's where he leaves off in this masterful work. 

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