Grow and Hide: The History of America's Health Care State

Grow and Hide: The History of America's Health Care State by Colleen M. Grogan

The United States spends huge amounts on health care, but only achieves middling health outcomes. Despite heavy dependence on private companies, American government spends more on the health system than many countries that have fully funded government health systems. This book details the history of public healthcare and the way that the system has been steadily grown, while the true government involvement has been hidden.

At the outset, public health improvements were tied closely to sanitation improvements. Garbage collection and sewage handling were key areas of public health. Alas, this was al done in city governments, which were beholden to patronage systems. Doctors did not want to be beholden to random patronage employees, so worked to separate out public health from areas like trash collection. There was also a difference between "public health" and "individual health". This was deemed important and would lead to much of the "hiding" of true government health expenditures.

The health care system has continued with this grow and hide since. The healthcare industry is eager to take government funding when offered. The industry will even work to write regulations to their benefit. Then they will complain about state interference when it gets in the way. Both Democrats and Republicans are guilty of expansion of this super expensive highly-regulated healthcare system. the current "privately funded" healthcare system has become a means where the maximum number of private entities can extract government money. Investors, such as private equity have realized this and swept in to get their share of the healthcare bonanza. All in all, ths US likely spends more public money on healthcare, yet also requires citizens to spend a huge amount of private money to top it off. With so many feeding at the trough, reform has become difficult, and attempts often lead to more benefits for the entrenched interests. (See Obamacare). The book does a great job of identifying the problem and its history, which alas, has few easy solutions.