THE TEN YEAR WAR

In a book that took 10 years to research and write, journalist Cohn offers a thorough history of the persistent controversy over health care insurance in the U.S.

In other developed countries, writes the author, governments “are firmly in charge, using some form of taxes or mandatory premiums to finance benefits.” But the U.S. has seen an often vociferous debate “over what obligations society has to its most vulnerable members.” Cohn provides an informative overview of health coverage efforts beginning in the 1920s. Franklin Roosevelt, Truman, Kennedy, Johnson, and Carter all supported public health plans, but they faced opposition from private insurers and conservative politicians. In the 1980s, Ronald Reagan led that opposition as president, tapping into widespread anger over federal support programs. Bill Clinton’s efforts to devise a plan encountered opposition from multiple fronts, including within his own party. In 2006, as governor of Massachusetts, Mitt Romney instituted bold reforms that gave the state’s citizens better access to health care and increased financial security, a model that later inspired Obama’s plans for national health care. Nevertheless, in 2010, Scott Brown won election as senator from Massachusetts by attacking Romney’s measure “as a corrupt, secretive exercise by political insiders.” Cohn traces the fraught development of the Affordable Care Act, the controversy and compromises that led to its passage, and the continuing debate. Republican opposition, he asserts, began immediately after the law was signed on March 23, 2010, and became a rallying cry for Trump and his supporters. “At its core,” Cohn writes, “universal health care is all about common strength in common vulnerability. It’s a recognition that anybody can get sick or injured—that, by pooling resources together, everybody will be safe. It’s the same exact concept as Social Security and Medicare, and why the party responsible for them has spent nearly a century trying to extend health care guarantees to the rest of the population.”

A timely contribution to the literature on an urgent issue.