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Touching the Third Rail: The Politics of American Health Care

Since Theodore Roosevelt first called for national health insurance nearly a century ago, U.S. presidents have tried and failed to provide universal health benefits to all Americans. Today, the U.S. has the most highly privatized and expensive system in the world, with one in six dollars spent on health care and an estimated 46 million Americans left uninsured.

Restructuring America's health care system is now President Obama's top legislative priority. But during the August recess, irate opponents of his health care proposals confronted Democrats on the town hall circuit with inflammatory accusations, including outright distortions. The intensity of the debate galvanized the attention of the national media and caught the Obama administration off-guard.

What can we learn from the history of major health care policy debates? How did Lyndon Johnson win passage of Medicare and Medicaid, when Harry Truman and Bill Clinton failed to advance their versions of health care reform? How does the process work on Capitol Hill and when, if ever, can we expect to see this issue come to a vote?

Larry Jacobs holds the Walter and Joan Mondale Chair for Political Studies and directs the Center of the Study of Politics and Governance at the Humphrey Institute of Public Affairs. An expert in American politics and policy, he is the author of ten scholarly books including The Health of Nations: Public Opinion and the Making of U.S. and British Health Policy and Healthy, Wealthy, and Fair, as well as articles on health reform in The New England Journal of Medicine and elsewhere. He is the recipient of numerous prestigious awards including the Robert Wood Johnson Investigator Award in Health Policy Research. Professor Jacobs received a Ph.D. in political science from Columbia University and joined the faculty of the University of Minnesota in 1988.

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