The US government has always invested federal, state, and local dollars in public health protection and prevention. Despite this public funding, however, Americans typically believe the current system is predominantly comprised of private actors with little government interference. In Grow and Hide, Colleen M. Grogan details the history of the American health care state and argues that the public has been intentionally misled about the true role of government.
The US created a publicly financed system while framing it as the opposite in what Grogan terms the "grow-and-hide regime." Today, the state's role is larger than ever, yet it remains largely hidden because stakeholders have repeatedly, and successfully, presented the illusion of minimal government involvement. The consequences of this narrative are scarce accountability and a highly unequal distribution of benefits.
As Grogan reveals, America has never had a system that resembles a competitive, free-market model. Given how much the government already invests in the health care system, how these funds are distributed and administered are fundamental political questions for the American public. If we want to fix care in America, we need to reimagine the way it is organized, prioritized, funded, and, perhaps most importantly, discussed.
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