Book Two: Chapter One: The Mirage of Reform.

In reading Starr’s discussion of health insurance, and its predecessor life insurance, I was in for a surprise. I had no idea that Americans were so keen on avoiding a “pauper burial” and funding expenses for their ‘final’ illness-- I wonder how that could have ascertained at a time prior to the person’s demise. Could the vast success of these programs have been the direct result of extensive marketing campaigns by the “army of insurance agents” Paul Starr refers to. The modern equivalent to this would be something I see in my own community: people buying graveyards and spending lavishly to ensure that they get a good spot, whatever that may be. Investment in the afterlife seems to be popular across ages and cultures, but not the need to provide medical care for those who cannot afford it.

With all the media coverage of the ongoing debate about the Affordable Care Act, so deprecatingly named the Obamacare and after reading this chapter, it seems as though aborting plans for national health insurance is somehow part of the way Americans always prefer to shape their healthcare system.
The development of health insurance was far from a philanthropic, empathic act. It was all about business and any efforts opposing the liberal enterprise are frowned at--or even repelled. The way Starr eloquently summarizes the situation as a battle between two opponents, both representing beliefs deeply rooted in the American belief system: liberty and efficiency. And public opinion being “malleable” is easily played up by making one case or the other seem more righteous, or more in line with American values.
Paul Starr argues that whether one side or the other wins has nothing to do with one set of values being more deeply rooted in the American people; and that the imbalance of resources ironically was in both sides’ favor. I find these observations enlightening. I had yet to see lack of resources as an advantage, but it made a whole lot of sense in this context.