While the Obama administration's Patient Protection and Affordable Care Act (ACA) has expanded health care coverage for millions of Americans, it has fallen short in offering universal health care to all. In Health Care as a Right of Citizenship, Gunnar Almgren argues that the ACA's primary significance is not in its expansion of health care entitlements but in its affirming by an act of Congress the idea that comprehensive health care must be available to all as a right of citizenship. The mainstream American public now views access to affordable health care to all citizens as a crucial function of just and effective governance―and any proposed alternative to the ACA must be reconciled with that expectation. This ambitious book examines how the American health care system must be further reformed to bring it closer in line with the ideals of a modern democracy, as well as how the ACA may change in the coming years. It suggests the next, natural step in the realization of health and well being as a fundamental human right.
Based on a close analysis of the writings of sociologist TH Marshall and philosopher John Rawls, this book examines the theoretical foundations for health care as a social right of citizenship. Almgren then translates these theoretical principles into core health care policy aims. Throughout, he argues that the ACA is but an evolutionary step toward a more radical and fundamental health care reform. Almgren suggests how such a restructured health care system might operate, with specific proposals for its financing and delivery systems. He also explores the special issues and considerations that all nations must grapple with as they seek to provide a sustainable social right to health care.
Health Care as a Right of Citizenship will stimulate and challenge readers who take an interest in America's health care policy, particularly those who wish for a health care system that is both financially sustainable and capable of making healthcare accessible, adequate, and affordable to all Americans, irrespective of their societal position and individual health needs.
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Gunnar Almgren is a professor in the School of Social Work at the University of Washington and a faculty research associate at the University of Washington Center for Studies in Demography and Ecology. He is the author of The Safety Net Health Care System (2011) and Health Care Politics, Policy, and Services: A Social Justice Analysis, Second Edition (2012).
Almgren presents an extensively detailed and well-sourced story of the precursors to the Affordable Care Act of 2010, a "principled critique" of the ACA as it currently stands, and a proposal for the path (or paths?) forward. The book is beautifully written and a great read. (Karla Washington, University of Missouri)
For the past two decades health scholars have documented the existence and prevalence of health disparities with a recent intentional shift away from additional documentation of health disparities to a focus on possible solutions for achieving health equity. Almgren's book argues that these micro level efforts may be largely in vain if we do not also address the larger systematic design issues. This book can be used to assess the multiple dimensions of equity in the US health care system, and to develop health care reforms to remedy where equity falls short. (Colleen Grogan, University of Chicago)
Almgren's book on health reform could not be more timely. In the aftermath of the US presidential campaign, where the concept of a right to health care reemerged (as well as calls for complete abandonment of the Affordable Care Act), we need a principled, historically grounded, thoughtful, and yes, radical rethinking of the American dilemma of health care coverage. This book knits it all together and makes compelling sense of our confusing health care policy world. (Edward F. Lawlor, Brown School, Washington University in St. Louis)
This clearly written book offers a concise review of the unique history of the U.S. health care and health insurance system, a well-reasoned presentation of the ethical basis of a universal right to health care, a comprehensive examination of the Affordable Care Act in the context of these ethical principals, and a map for the way forward, taking historical trajectory and ethical aspirations into account. What an invaluable resource for the health policy readership! (Janet M. Bronstein, University of Alabama at Birmingham, author of Preterm Birth in the United States: A Sociocultural Approach)
The revolutionary title does justice only to the initial chapters of this well-crafted book. (P. Rodriguez del Prozo Choice)
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