1. The term is Harold L. Wilensky's; see his The Welfare State and Equality: Structural and Ideological Roots of Public Expenditures (Berkeley: University of California Press, 1975).

This account draws largely but not exclusively on the following sources. Recent general accounts of public policy with respect to medical care include: Lawrence D. Brown, Politics and Health Care Organization: HMOs as Federal Policy (Washington, D.C.: Brookings, 1983); Karen Davis, National Health Insurance: Benefits, Costs, and Consequences (Washington, D.C.: Brookings, 1975); Alain Enthoven, Health Plan: The Only Practical Solution to the Soaring Cost of Medical Care (Menlo Park, Calif.: Addison-Wesley, 1980); and Paul Starr, The Social Transfor - soft

mation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry (New York: Basic Books, 1982).

Recent but more specific accounts include: Henry J. Aaron and William B. Schwartz, The Painful Prescription: Rationing Hospital Care (Washington, D.C.: Brookings, 1984); Martha Derthick, Policymaking for Social Security (Washington, D.C.: Brookings, 1983) chaps. 15 and 16; Paul T. Menzel, Medical Costs, Moral Choices: A Philosophy of Health Care Economics in America (New Haven: Yale University Press, 1983); and Ann Shola Orloff and Theda Skocpol, "Why Not Equal Protection? Explaining the Politics of Public Social Welfare in Britain and the United States, 1880s-1920s," paper presented at the 1983 annual meeting of the American Sociological Association, Detroit, September 2.

Older but still useful general accounts include: Daniel S. Hirschfield, The Lost Reform: The Campaign for Compulsory Health Insurance in the United States from 1932 to 1943 (Cambridge: Harvard University Press, 1970); Roy Lubove, The Struggle for Social Security, 1900-1935 (Cambridge: Harvard University Press, 1968); and Theodore R. Marmor, The Politics of Medicare (Chicago: Aldine, 1973).

On the consequences of Medicare see Henry R. Brehm and Rodney M. Coe, Medical Care for the Aged: From Social Problem to Federal Program (New York: Praeger, 1980); and Stephen Davidson and Theodore R. Marmor, The Cost of Living Longer: National Health Insurance for the Elderly (Lexington, Mass.: D.C. Heath, 1980). On the consequences of Medicaid see Karen Davis and Cathy Schoen, Health and the War on Poverty: A Ten-Year Appraisal (Washington, D.C.: Brookings, 1978), chaps. 1, 2, 4, 6, and 7.

For statistics on Medicare see Congressional Budget Office, Changing the Structure of Medical Benefits: Issues and Options (Washington, D.C.: Congressional Budget Office, 1983); and selected issues of the Social Security Bulletin .

2. Crusade is an appropriate term in light of Samuel Huntington's description of this period as one of "creedal passion"; see his American Politics: The Promise of Disharmony (Cambridge: Harvard University Press, 1981).

3. See Carleton B. Chapman and John M. Talmadge, "The Evolution of the Right-to-Health Concept in the United States," in Maurice B. Visscher, ed., Humanistic Perspectives in Medical Ethics (Buffalo, N.Y.: Prometheus, 1972), pp. 72-134, especially pp. 94-103.

4. Hirschfield, Lost Reform , passim.

5. See Davis and Schoen, Health and the War on Poverty , chap. 5.

6. Marmor, Politics of Medicare , pp. 14-16.

7. Marmor, Politics of Medicare , pp. 25 and 53. On the extension of continue

social security to disabled workers, see Derthick, Policymaking , chap. 15.

8. Brown, Politics and Health Care , pp. 195-96.

9. For a comparison of various proposals see Davis, National Health Insurance , chap. 5; and Davidson and Marmor, Cost of Living Longer , chap. 5.

10. Other beneficiaries include railroad retirement recipients, persons receiving social security disability payments, and some kidney dialysis patients. For most of these persons the criterion of effort is still applicable.

11. For details of coverage see Brehm and Coe, Medical Care for the Aged , pp. 59-63; or Davidson and Marmor, Cost of Living Longer , pp. 35-40.

12. Brehm and Coe, Medical Care for the Aged , pp. 41-42.

13. See Ivan D. Illich, Medical Nemesis: The Expropriation of Health Care (New York: Bantam, 1977).

14. Guido Calabresi and Philip Bobbit, Tragic Choices (New York: Norton, 1978); Menzel, Medical Costs, Moral Choices , p. 138.

15. Menzel, Medical Costs, Moral Choices , p. 82.

16. Marmor, Politics of Medicare , pp. 67, 86, and 122-23.

17. M. Kenneth Bowler, "Changing Politics of Federal Health Insurance Programs," PS 20 (Spring 1987):202-11.

18. Starr, Social Transformation , bk. 2, chap. 5.

19. Starr, Social Transformation , p. 311 and bk. 2, chap. 5.

20. Davis and Schoen, Health and the War on Poverty , p. 97; Congressional Budget Office, Changing the Structure of Medical Benefits , pp. 11-12; Social Security Bulletin 51 (July 1988).

21. See Enthoven, Health Plan , pp. 16-32; and Davis and Schoen, Health and the War on Poverty , p. 97.

22. John Holahan and John L. Palmer, "Medicare's Fiscal Problems" (Washington, D.C.: Changing Domestic Priorities Project, Urban Institute, 1987).

23. See Enthoven, Health Plan , pp. 27-28 and 105-6; and Bowler, "Changing Politics of Health Insurance."

24. Enthoven, Health Plan , pp. 32-36.

25. See Brehm and Coe, Medical Care for the Aged , pp. 68-77; and Menzel, Medical Costs, Moral Choices , pp. 120 and 138.

26. Brown, Politics and Health Care , pp. 206-8; but see as well pp. 462-64.

27. Enthoven, Health Plan , pp. 82-89.

28. Enthoven, Health Plan , pp. 84-88; and Brown, Politics and Health Care , pp. 377-82.

29. Brown, Politics and Health Care .

30. See Brown, Politics and Health Care , pp. 234 and 360. break

31. On the need for regulation under competitive and current market conditions, see Brown, Politics and Health Care , pp. 228, 234, and 360; Enthoven, Health Plan , pp. 78-82.

32. Brown, Politics and Health Care , p. 527; and Davis and Schoen, Health and the War on Poverty , pp. 212-13; and Davidson and Marmor, Cost of Living Longer , chap. 5.

33. Davis and Schoen, Health and the War on Poverty , p. 92.

34. Brehm and Coe, Medical Care for the Aged , pp. 63-64 and 95.

35. These terms as well as accountability and acceptability —Medicare doing better on the latter—come from Brehm and Coe, Medical Care for the Aged , p. 130.

36. Davis, National Health Insurance , p. 73.

37. Davidson and Marmor, Cost of Living Longer , p. 12.

38. "President Carter's National Health Plan Legislation: Detailed Fact Sheet" (Washington, D.C.: Department of Health, Education, and Welfare, June 12, 1979).

39. But see Louise B. Russell, Is Prevention Better Than Cure? (Washington, D.C.: Brookings, 1986).

40. Brehm and Coe, Medical Care for the Aged , pp. 79-81.

41. Marmor, Politics of Medicare , p. 25.

42. See particularly, Enthoven, Health Plan , pp. 105-6.

43. Starr, Social Transformation , bk. 2, chap. 5, discusses this decline but has a glum view of it.

44. Charles Lockhart, "Values and Policy Conceptions of Health Policy Elites in the United States, the United Kingdom, and the Federal Republic of Germany," Journal of Health Politics, Policy and Law 6 (Spring 1981):98-119, particularly pp. 103-5.