The Wages of Sickness

The Politics of Health Insurance in Progressive America

By Beatrix Hoffman

280 pp., 6.125 x 9.25, 10 illus. , notes, bibl., index

  • Paperback ISBN: 978-0-8078-4902-6
    Published: January 2001
  • E-book EPUB ISBN: 978-0-8078-6072-4
    Published: June 2003
  • E-book PDF ISBN: 979-8-8908-7157-2
    Published: June 2003

Studies in Social Medicine

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The Clinton administration's failed health care reform was not the first attempt to establish government-sponsored medical coverage in the United States. From 1915 to 1920, Progressive reformers led a spirited but ultimately unsuccessful crusade for compulsory health insurance in New York State. Beatrix Hoffman argues that this first health insurance campaign was a crucial moment in the creation of the American welfare state and health care system. Its defeat, she says, gave rise to an uneven and inegalitarian system of medical coverage and helped shape the limits of American social policy for the rest of the century.

Hoffman examines each of the major combatants in the battle over compulsory health insurance. While physicians, employers, the insurance industry, and conservative politicians forged a uniquely powerful coalition in opposition to health insurance proposals, she shows, reformers' potential allies within women's organizations and the labor movement were bitterly divided. Against the backdrop of World War I and the Red Scare, opponents of reform denounced government-sponsored health insurance as "un-American" and, in the process, helped fashion a political culture that resists proposals for universal health care and a comprehensive welfare state even today.

About the Author

Beatrix Hoffman is assistant professor of history at Northern Illinois University in DeKalb.
For more information about Beatrix Hoffman, visit the Author Page.


"Tightly argued and well crafted. . . . This is an excellent book that should interest historians of public health, business, labor, women, and public policy."--Journal of American History

"A timely, well-written, and amply researched new look at the most promising effort to pass a state government health insurance program . . . . Hoffman's most significant contribution is to bring women into the struggle for health care reform as active and critical participants . . . . Hoffman's admirable accomplishment has been to recover an important and early part of the century of struggle for compulsory health insurance: the work of women activists and analysts."--American Historical Review

"Nicely written and deeply researched. . . . Hoffman adds much to the conventional narrative. . . . Hoffman has produced a very fine book that . . . suggests many intriguing questions."--Labor History

"[This] book weaves the interests of disparate influences such as employers, labor unions, medical doctors, women's groups, and politicians into a fascinating narrative. . . . The volume is both extensively documented and written in lively, readable prose. It will appeal to students of a wide range of disciplines, from history to public policy."--Choice

"Beatrix Hoffman has reframed the formative years of American health policy in a most innovative way. Her vivid description and compelling explanation of progressive failure should greatly interest all those concerned with health security as a historical problem or a contemporary one."--Alan Derickson, Pennsylvania State University