The debate over the U.S. government's role in health care financing:"deja vu,all over again"

Yogi Berra's famous quote captures the continuing debate over the legitimate role of the U.S. government in health care financing. The issues of individual choice, equity of access, and concern about income security are just as unresolved today as they were in the early twentieth century. Until we engage in an explicit national debate on these issues and come to a national consensus on the human and political values underlying our current health care situation, a “solution” to the health care financing problems will never be found. This article discusses the history of the issue of government's involvement in health care financing, American ambivalence about government regulation, and the role of American business as a major health care insurer.     

The history of urban fiscal politics in America, 1830-1930: what was supposed to be versus what was and the difference it makes

Across the social sciences in America analysts routinely employ the so-called “functional“ model of the urban political machine in their explanations of the development of American urban government. They do so, however, with little knowledge of the intellectual history of this model or the actual history of American urban politics. This essay reviews the development and spread of the functional model through the social sciences and argues that it is an historical construct developed in the nineteen fifties by analysts who were admittedly more interested in creating a “usable past” for liberal political economy than in understanding urban political history. Having done this the essay then reviews recent work by urban historians and sociologists which have put the propositions of this model to the test in its ideological, political, and fiscal contexts for the years from 1830-1930. This work reveals that the image of the “all-powerful” political machines is demonstrably false. On this basis the essay argues that the persistence of this image has led to a unrealistic historical standard against which contemporary urban public administration has been unfairly judged.