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Examines why the U.S. is the only industrialized nation without universal health insurance coverage

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Copyright © 2004, University of Michigan. All rights reserved. Posted January 2005.

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Universal health coverage has become the Mount Everest of public policy in the United States: the most daunting challenge on the political landscape. But, despite numerous attempts, all efforts to achieve universal health care have failed. In Universal Coverage, Rick Mayes examines the peculiar and persistent lack of universal health coverage in America, its economic and political origins dating back to the 1930s, and the current consequences of this significant problem.

Rick Mayes is an Assistant Professor of Public Policy in the University of Richmond's Department of Political Science and a Faculty Research Fellow at the University of California, Berkeley's Petris Center on Healthcare Markets and Consumer Welfare.

"This book makes a genuine contribution to the literatures on political institutions and interest groups."
---Kevin Esterling, Assistant Professor, UC-Riverside

- Kevin Esterling, Assistant Professor, UC-Riverside

"Aaron Wildavsky said good policy studies should use policy as a window on politics. Mayes does it brilliantly."
---Deborah Stone, Professor, Dartmouth College

- Deborah Stone, Professor, Dartmouth College

"A readable and accessible account that is informed by previous scholarship yet backed up by telling details from historical archives."
---Jacob Hacker, Professor, Yale University

- Jacob Hacker, Professor, Yale University

"Accessible, cleverly argued, and provocative. Mayes provides fresh answers to the enduring question of why the U.S. lacks national health insurance."
---Jonathan Oberlander, UNC-Chapel Hill, Author of The Political Life of Medicare

- Jonathan B. Oberlander

“Among the many books that have attempted to explain the failure of the United States to adopt a universal health insurance system Rick Mayes’ book, Universal Coverage: The Elusive Quest for National Health Insurance, stands out for breaking a new pathway. In explaining the failure to adopt universal health insurance coverage in the United States, most scholars have tended to focus on influence of policy processes and have attributed the failure to either ideological, interest group, or institutional factors. Professor Mayes advances the theoretical argument much further by suggesting that public policies themselves must be seen as important variables that influence political actors and processes. He argues that policymaker’s successes with incremental expansions (critical junctures) such as Social Security and Medicare fostered a pattern of increasing return which locked in specific pathways and patterns of policy making that has had a detrimental consequence for adoption of universal health insurance coverage. A must read book for anyone interested in understanding why United States remains the only major industrialized nation in the world without a universal health insurance system.”
---Kant Patel, Professor of Political Science and co-author of, The Politics of Public Health in the United States

- Kant Patel

"Mayes is highly knowledgeable about health policy and his writing is clear and spirited."
---Martha Derthick, Emeritus Professor, University of Virginia

- Martha Derthick, Emeritus Professor, University of Virginia

"For health care professionals interested in understanding more about the subject [universal coverage or national health insurance], Mayes' efficient account of the key turning points, tensions, and interest groups is quite possibly the best way to reach an appreciation for why we are in the perplexing state we're in and how difficult it will be to reach universal coverage."
--Journal of the American Medical Association

- Timothy G. Ferris, M.D.

"Rick Mayes provides a political history of the reform movement that demonstrates why it seems almost improbable that national health insurance ever could have reached the threshold of political feasibility. . . . [and he] fills in the blanks in confronting the complexities of health care reform. . . ."
---New England Journal of Medicine

- Don R. McCanne, M.D.