Toward a Healthy Society

The Morality and Politics of American Health Care Reform

Milton Fisk

Few issues concern the American public today more than health care. Just ask anyone who has sat for hours in an HMO waiting room or made countless phone calls trying to have a claim settled-or anyone who can't get coverage. But whenever basic reform is proposed the insurance industry opens a massive campaign against it.

Health care today is part of big business, which in defeating the Clinton plan successfully pushed any kind of basic reform off the political agenda. Continuing citizen support for some form of public insurance is, says Milton Fisk, a sign that basic reform is still possible. In his new book, he argues persuasively that basic reform goes beyond a matter of life and death-it's integral to maintaining a society where concern for others holds its own against the market.

“The best book on health care reform in the last decade—philosophically deep, politically astute, and legally fascinating. Fisk makes his case for reform cogently and in a manner that is fair-minded, reasonable, and eminently respectful of the different voices that speak within a multicultural democracy. This superb original analysis of U.S. ‘corporate’ medicine will be very useful.”

—Rosemarie Tong, author of Controlling Our Reproductive Destiny and Feminist Approaches to Bioethics

Health care, observes Fisk, is not simply an individual responsibility but a public good much like education, and commitment to the social values underlying these public goods is essential to any just society. A healthy society as a value worth pursuing becomes an empty slogan when the poor get inferior health care, when workplaces are dangerous to health, and when a focus on medical treatment leaves out our bodies' environment.

Taking in the broad sweep of social policy in the last half-century, Fisk describes the shift from welfare toward competitiveness as a key factor in the rise of corporate care in the United States. He analyzes the failure of the Clinton health care plan in detail and shows that its commitment to corporate health care was at odds with its reforming intent. He then argues that without national health insurance, needless obstacles will stand in the way of a healthy society. Ideally, the public fund behind this insurance would be derived from a progressive income tax.

Skillfully blending philosophy, economics, and public policy, Fisk's book breaks new ground in political morality and raises important questions about the way people's needs for health care are being defined to satisfy corporate priorities. At a time when so many Americans can barely afford to get sick, no one concerned with this issue can afford to ignore this work of realism and vision.

About the Author

Milton Fisk is professor emeritus of philosophy at Indiana University and has been active in the movement to reform the health care system. He is also the author of Nature and Necessity, Ethics and Society, and The State and Justice.