This dissertation examines the role of public opinion in President Clinton's 1993–94 proposal for comprehensive national health insurance. The dissertation challenges the dominant interpretation of the 1993–4 health care debate: that the public wanted universal health care, Clinton attempted to deliver it to them, but failed because of a flawed political process. Different analysts see different flaws, but most agree that the health care debate was indicative of an â€unhealthy†political process, where special interests dominated a debate marred by misinformation and big money. Some go so far as to conclude that universal health care is â€terminally ill,†forever doomed by an institutional structure that fragments power, allowing well-organized, well-financed special interest groups to easily dominate the political playing field. Using public opinion and archival data, the central findings include: (1) The public did not ever strongly support the Clinton Plan. A majority initially supported the Clinton plan, but felt the plan would affect them adversely; (2) Public support of the Clinton Plan would have dissipated, even without the unprecedented campaign waged against it by business interests; (3) Elected officials listened to the public. Public opinion affected the health care debate in important ways. Clinton eschewed the so-called â€single payer†approach to health care, fearing adverse public reaction. Second, anticipating hostile public opinion, Democrats in the House of Representatives froze their chamber's consideration of the health care reform until the Senate spoke on controversial aspects of the plan. And public opinion directly affected senators' decisions to support or oppose health reform. In particular, Senate Republicans sought to kill health reform when the polls turned against the Clinton Plan. The debate over health reform, while imperfect in many ways, was still indicative of healthy political process. The Clinton Plan forced a debate about the role of government in American society. Here, as in many cases, the public showed both support for the ends of the government involvement but discomfort in granting the government broad new powers. The public understood the broad choices the Clinton Plan presented and rejected it. Moreover, that the public significantly influenced public policy.

This work analyses whether the polls in 1993 and 1994 misled US policy makers about the urgency of health care reform. It reviews the attitudes of Americans about their own health care, their concerns about reform of the system, and the views they hold about the importance of the issue.

Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

The first attempt to integrate data from all of the National Health Care Survey (NHCS) components into one publication that examines how health care utilization is changing across multiple settings.