$31.00
FREE delivery Thursday, May 9 on your first order. Details
Or fastest delivery Tomorrow, May 6. Order within 4 hrs 43 mins. Details
Only 4 left in stock (more on the way).
$$31.00 () Includes selected options. Includes initial monthly payment and selected options. Details
Price
Subtotal
$$31.00
Subtotal
Initial payment breakdown
Shipping cost, delivery date and order total (including tax) shown at checkout.
Payment
Secure transaction
Your transaction is secure
We work hard to protect your security and privacy. Our payment security system encrypts your information during transmission. We don’t share your credit card details with third-party sellers, and we don’t sell your information to others. Learn more
Payment
Secure transaction
We work hard to protect your security and privacy. Our payment security system encrypts your information during transmission. We don’t share your credit card details with third-party sellers, and we don’t sell your information to others. Learn more
Ships from
Amazon.ca
Ships from
Amazon.ca
Sold by
Amazon.ca
Sold by
Amazon.ca
Returns
Eligible for Return, Refund or Replacement within 30 days of receipt
Eligible for Return, Refund or Replacement within 30 days of receipt
This item can be returned in its original condition for a full refund or replacement within 30 days of receipt.
Read full return policy
Returns
Eligible for Return, Refund or Replacement within 30 days of receipt
This item can be returned in its original condition for a full refund or replacement within 30 days of receipt.
Read full return policy
Kindle app logo image

Download the free Kindle app and start reading Kindle books instantly on your smartphone, tablet or computer – no Kindle device required.

Read instantly on your browser with Kindle for Web.

Using your mobile phone camera, scan the code below and download the Kindle app.

QR code to download the Kindle app

Follow the author

Paul Starr
Follow
Something went wrong. Please try your request again later.

The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry Paperback – May 30 2017

by Paul Starr (Author)
4.6 4.6 out of 5 stars 197 ratings
See all formats and editions
{"desktop_buybox_group_1":[{"displayPrice":"$31.00","priceAmount":31.00,"currencySymbol":"$","integerValue":"31","decimalSeparator":".","fractionalValue":"00","symbolPosition":"left","hasSpace":false,"showFractionalPartIfEmpty":true,"offerListingId":"y5ghqwUka9zav3XMROl9HKTr4F6NjWvlTf1eunmp0SqLqOygJZ0E9vZiT3VHvZvzSTeId6kk39wL%2Fvfv6XVhH7Me%2FOc739sL1l6GmLG9vjh%2BKi2A2COxFjRRU1x9aypnQXUCJUCSZCQ%3D","locale":"en-CA","buyingOptionType":"NEW","aapiBuyingOptionIndex":0}]}

Purchase options and add-ons

“A monumental achievement” (New York Times) and the winner of the Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of the American health care system.
 
Considered the definitive history of the American health care system, The Social Transformation of American Medicine examines how the roles of doctors, hospitals, health plans, and government programs have evolved over the last two and a half centuries. How did the financially insecure medical profession of the nineteenth century become a prosperous one in the twentieth? Why was national health insurance blocked? And why are corporate institutions taking over our medical system today? Beginning in 1760 and coming up to the present day, renowned sociologist Paul Starr traces the decline of professional sovereignty in medicine, the political struggles over health care, and the rise of a corporate system.
 
Updated with a new preface and an epilogue analyzing developments since the early 1980s, The Social Transformation of American Medicine is a must-read for anyone concerned about the future of our fraught health care system.
 
Previous page
  1. ISBN-10
    0465093027
  2. ISBN-13
    978-0465093021
  3. Edition
    2
  4. Publisher
    Basic Books
  5. Publication date
    May 30 2017
  6. Language
    English
  7. Dimensions
    15.24 x 3.81 x 23.5 cm
  8. Print length
    592 pages
  9. See all details
Next page

Frequently bought together

The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry
$31.00
Only 4 left in stock (more on the way).
Ships from and sold by Amazon.ca.
+
An American Sickness: How Healthcare Became Big Business and How You Can Take It Back
$25.99
Only 4 left in stock (more on the way).
Ships from and sold by Amazon.ca.
+
America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System
$25.00
Temporarily out of stock.
Order now and we'll deliver when available. We'll e-mail you with an estimated delivery date as soon as we have more information. Your account will only be charged when we ship the item.
Ships from and sold by Amazon.ca.
Total price:
To see our price, add these items to your cart.
Details
Added to Cart
Some of these items ship sooner than the others.
Show details Hide details
Choose items to buy together.

From the Publisher

med

med

med

Product description

Review

"The definitive social history of the medical profession in America....A monumental achievement."―New York Times Book Review

"Superb sociology, superior history--and essential reading for anyone interested in the fate of American medicine."―Newsweek

"The most ambitious and important analysis of American medicine to appear in over a decade.... If you read only one book about American medicine, this is the one you should read."―Ronald Numbers, author of The Creationists: The Evolution of Scientific Creationism

About the Author

Paul Starr is a professor of sociology and public affairs at Princeton University and holds the Stuart Chair in Communications and Public Affairs at the Woodrow Wilson School of Public Affairs. A multiple prize-winning author of several books and the cofounder and coeditor of The American Prospect, Starr lives in Princeton, New Jersey.

Product details

  • Publisher ‏ : ‎ Basic Books; 2 edition (May 30 2017)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 592 pages
  • ISBN-10 ‏ : ‎ 0465093027
  • ISBN-13 ‏ : ‎ 978-0465093021
  • Item weight ‏ : ‎ 621 g
  • Dimensions ‏ : ‎ 15.24 x 3.81 x 23.5 cm
  • Customer Reviews:
    4.6 4.6 out of 5 stars 197 ratings

About the author

Follow authors to get new release updates, plus improved recommendations.
Paul Starr

Paul Starr

Brief content visible, double tap to read full content.
Full content visible, double tap to read brief content.

Discover more of the author’s books, see similar authors, read author blogs and more

Customer reviews

4.6 out of 5 stars
4.6 out of 5
197 global ratings

Top reviews from Canada

Luke Lin
5.0 out of 5 stars Great history of American medicine
Reviewed in Canada on January 8, 2004
For anyone interested in the healthcare as a profession or area of study, I can't recommend this book highly enough. Despite the 20 years since its publication, Paul Starr's Pulitzer prize winner is still relevant today and in retrospect his projections made of the future of healthcare in America are surpisingly prescient.
The first book describes the development of the medical profession in early America providing a fascinating look at the social evolution of American society. The second book delineates the rise of doctors, hospitals and medical schools in latter half of the 19th to the early 20th century with the rise of science and a professional authority. The third book shifts the focus from the doctors and to the industry that medicine became as well as the various attempts at healthcare reform in response to rising healthcare costs.
My only criticism is that Starr should have devoted more pages to the root causes behind the rising healthcare costs that drove the reforms of the 1960-70s described in the third book.
Helpful
 Report
George Nilsen
5.0 out of 5 stars Blame it on the AMA
Reviewed in Canada on October 18, 2003
This book traces the evolution of America's disjointed healthcare system, from the horror of the early hospitals to the formation of the medical profession. It also explains how, as the early profession was fighting for the right to exist, it took virtual possession of the rest of the healthcare system. Every Democratic president since FDR has attempted some type of major healthcare reform, only to be opposed by the American Medical Association (AMA) because organized doctorhood thought it had too much to lose.
This book is an effortless read for students of sociology or those that have a great interest in the history of medicine. Published in 1983, it easily predicts some of the current problems in American healthcare, because the powerful interests that determine the delivery of healthcare are still the same. It also predicts some of the circumstances that will finally bring America around to some sort of rational, universal, healthcare coverage.
Helpful
 Report
Geodog
5.0 out of 5 stars Why the US has a private health care system
Reviewed in Canada on May 4, 2003
This Pulitzer Prize winning history of American Medicine does a lot to explain why the domain of public health is so small in the U.S., and why health in the U.S. is mostly a private, as opposed to public, matter. It takes some fortitude to get through, but it should be required reading for anyone who has ever wondered why, for better and for worse, the US is the only developed country that does not have social provision of medical care. Hint: It's not an accident. Recommended
Helpful
 Report
Ellen Steinhart
5.0 out of 5 stars A Comprehesive History
Reviewed in Canada on December 2, 2002
It was a pleasure to read Starr's enlightening, comprehensive journey of medicine in it's infancy to it's state in 1985. I hope to see an updated version filling in the intervening 17 years. An excellent book. I highly recommend it.
Helpful
 Report
Hclaw
5.0 out of 5 stars Starr review
Reviewed in Canada on September 26, 2002
A very accesible read. It easily combined my interest in social history and health care.
Helpful
 Report

Top reviews from other countries

R. L. Zobell
5.0 out of 5 stars A Definitive Book about the US Healthcare System
Reviewed in the United States on October 1, 2021
Verified Purchase
I am a physician engaged in the US healthcare system for the past 50 years. I read Starr's book first in 1985. For me, engaging this book was like "Saul on the road to Tarsus" . The film fell away from my eyes and for the first time, I began to "see" the American healthcare system. The complete title of the book is: "The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a VAST INDUSTRY". The title is completely apt and accurate. US medicine has experienced transformation and will continue to undergo change. American physicians as a profession boot-strapped themselves into a dominant force that effectively protected the boundaries of the profession from any outside encroachment up until around the 1990s. US doctors did not possess the status of a "sovereign state within a state" but they came close. For assorted reasons that Starr illuminates, doctors came to a point in the late 20th century where they no longer could keep "big business" at bay or curb inexorable relentless price inflation in medical goods & services. They fought a rearguard action for several decades against the "marauding barbarians at the gate" until such time "Big Business" breached the Rhine River and invaded the US doctors' turf.

The second aspect of Starr's book title is described as the "Making of a Vast Industry". US Healthcare system (US HS) understood as a "Vast Industry" is a "vast" understatement. US Healthcare is a mega- gigantic, mind-numbingly immense "Industrial- Complex" unlike anything seen on the planet earth. The US HS was HUGE in the 1980s and 1990s;. Consequently, measures were set in motion to break the upward-directed cost curve. The rate of rise was moderated but THE RISE continued, and like an out-of-control Godzilla, scavenges the countryside - consuming vastly large sums of money lying loose in its pathway. For example, 2020 US health care expenditures approached $3.8 TRILLION.

Very few Americans could truly grasp just how much money $3.8 trillion is. To put that in perspective: If US Healthcare were a "sovereign country" it would rate 5th in the world - based on the size of its GDP- exceeded only by China, Japan, and about tied with Germany. Walmart the largest corporation in America based on yearly revenue takes in ~ $546 B; Amazon takes in $347 B and 3rd place goes to Apple @ $ 274 B. Of the top 13 companies in the US Fortune 500 ranking, 5 companies belong to the "Healthcare Industry". Together these 5 companies haul in $1.6 TRILLION. The top 3 companies: Walmart, Amazon, and Apple together collect $1.17 Trillion. It was recently reported that US Big Pharma (J&J, Pfizer, Merck, Lily, etc) based on revenue generated from the sale of the TOP 20 Drugs absorbs >$100 Billion-- MORE than every other country on the planet- COMBINED!

AND, it's actually WORSE than it seems. Scholars have consistently observed over the past 30 years that the administrative overhead within "the system", i.e. transactional costs incurred in measuring, tracking, overseeing, controlling "the system" - consumes ~ 20% - 25% of the total costs. OR about $700 billion/ year. This overhead is considered "deadweight" "dross" "waste".

$700 billion in deadweight is appreciably more money than Walmart makes in an entire year. $700 billion is about the same amount of money the USA elects to spend yearly on "defense" - DoD procurements; AND this sector of spending ie "Arms & Weapons" is more than every country on the planet earth spends on "defense" - COMBINED!
Most countries in the OECD spend ~ 7% -13% on administrative costs.

Starr's book provides the seriously inquisitive student of US Healthcare Policy an explanation of how these staggering numbers came to be and why they continue to be relatively so immense.

Finally, Starr does not call into question healthcare service quality. It has been and remains very good. The primary problem is: it is so damn expensive!
Starr alludes to some of the reasons for this. The "Social Transformation of American Medicine", though, is a sociological analysis of the environment and of varied factors - a deep context - out of which a "Vast Industry" emerged and continues to thrive.
20 people found this helpful
 Report
JeffA
5.0 out of 5 stars American Delusion: 'Medical' Care is not 'Health Care'
Reviewed in the United States on April 3, 2011
Verified Purchase
This book is VERY worth purchasing and reading ... from beginning to end. Begin with the book's title and meditate on each word chosen by the author to describe the dilemmas confronting individual Americans whose hope is to be as well and comfortable as possible in their lives and in the lives of those they love.

For me the key word in the title which needs contemplation is "Sovereign". American physicians are granted a life tenure to 'practice' their craft; once having been licensed, the technical competence of individual physicians is never again questioned, except in the grossest of public cases. In America, to be a licensed medical doctor is as close to being 'king' and 'sovereign' that a child of immigrant children will ever have.

Why is this a problem? From the standpoint of the individual who 'hopes' to live well, be healthy, and integrate effectively with the socio-technical economy of his era ... this person equates 'Medical Care' with 'Health Care'. KEY: Physicians practice Medicine ... they do not practice Health. Only one to three percent of physicians in American have ever had even a single seminar on 'health' and what factors constellate into that dynamic mind, body, spiritual reality which we humans come to recognize as being 'healthy'.

Americans of 2011 are in the the grip of what the author has titled a vast industry. Individual come to recognize that they are 'not well' or are 'ill', or 'sick'; they want, hope, desire to be health, restored and at peace with their life and their body and relationships. These individuals make what they believe to be a reasonable, rational decision to seek help from their 'health care provider', their physician. But the elephant in the front room is the unspoken reality that their physician practices 'medicine' and not 'health'; medicine is Anything a licensed doctor says it is. There are few guarantees given to an individual who has 'health care benefits' in America ... but one of them is that the 'patient' will leave the transaction with large quantities of pharmaceutical products ... These are 'BENEFITS' of being a American being 'CARED FOR' by licensed and certified American medical practitioners and their collectivized organizations: HMOs, PPGs, etc.

This book is a history of the vast American clinical pharma industry. It is thought provoking ... and rightfully anxiety provoking because all is not right in the 'American Health Care'. I hope that you the reader of what I am writing can take a moment to reflect upon the time: total hours and rapid frequency ... with which your senses of sight and sound are inundated with Disney-esque marketing, advertizing and sales of pharmacological 'cures' to diseases invisible to your current minds. These advertisements are actually not directed to you ... they are directed toward your infants and your smaller children. Their consciousness are being primed and fixed to respond in a predictable manner to view pharma products and 'other stuff' as 'good and beneficial'

If you have a few minutes for a world class lesson ... Thomas Kuhn discussion on how clinical scientists are inculcated in their trade.

[...]

And the Flexner Report of 1910 (101 years ago) which created the groundwork for the sanctification of Medical practitioners. Note it was not until 1938 that a person visiting their physician was more likely to be helped than harmed by the events of that visit. ... Notice the correlation of arrival of Sulfa antibacterials and eventually the miracle of penicillin.

Buy the book ... read the book ... and Stop presuming that physicians are health care providers. Please

Jeff Anderson, RN, MS Comprehensive Health Planning.
20 people found this helpful
 Report
James V. Holton
5.0 out of 5 stars Slightly dated, but as prize-worthy now as it was then, and still quite relevant.
Reviewed in the United States on June 11, 2010
Verified Purchase
This book should have been required reading of politicians and talking-heads engaged in the health care reform debate a few months ago. The Social Transformation of American Medicine has aged only a bit. The last chapter is out of date, but its predictions are somewhat chilling--that doctors have more to fear from the corporate takeover of medicine than putative reform.
Starr takes a long historical view of the medical profession and the role of doctors in it, paying attention to ancillary issues like hospitals, public health policies, among others. Starr's book should shake loose a lot of commonly held chestnuts about medicine in the US, most prevalently that doctors always enjoyed unprecedented social status or that doctors used to operate in a free-market atmosphere. As the title suggests, Starr points out that medicine and medical care has transformed from being home-based to being, more or less, "industrial" (albeit controlled but what might be considered a cartel). Key to this transformation is the sovereignty accorded this profession, often at the expense of health care's accessibility, not to mention cost.
Starr is not afraid to mince words or leave inferences unstated. In particular (as stated before) that doctors always operated in a free market free from government regulation (indeed, regulation is one of the ways doctors "captured" medical care, that government intervention/investment had nothing to do with the reputation the US enjoys in experimental medicine or research, that health care "crises" have long roots in American history, and that the role of corporations in present-day medical care has again transformed American medicine (and will continue to do so. Part history, part sociology, and part public policy analysis, this book provides much useful info in judging the heal care debate.
18 people found this helpful
 Report
Zora
4.0 out of 5 stars Evolution of the American Health System
Reviewed in the United States on January 2, 2018
Verified Purchase
★★★★ from Zora on January 1, 2018

Evolution of the American Health System

I bought this book for a class on the history of health system in the US and enjoyed it very much. Even though it's dense, Starr writes in a way that can be understood by all, not just for health policy experts or historians. If your interested in this book check out Starr's book Remedy and Reaction about the health policy of the Affordable Care Act and the context in which it was passed and strategies used to pass the legislation. Also, check out his Ted Talk, American Struggle over Health Care Reform. This was a major book in the class, he is able to describe the different factors influencing the health system over the years which has created the health system the current health system. Given that the class used specific pages of the book for the class, I look forward to reading more of it on my own. If you are interested in health policy and the development of the unique health system in the US this is the right book for you.
12 people found this helpful
 Report
Desert Rat
5.0 out of 5 stars Good through 1965
Reviewed in the United States on February 17, 2016
Verified Purchase
The other reviewers have covered this book pretty well, so I would just like to make few additional points:
A- for anyone interested in the current debates regarding health care, health care insurance and the ACA, you should realize, and this book documents, that there has NEVER been a "free market" for medical care. Since the US Civil War era one group or another has had various degrees of cartel or monopoly power of the market for medical services. This makes all rational discussions difficult because there is consequently no documentable evidence to refer to as to what a free market would look like. This hinders debaters across the political spectrum.

B- This is a social history and at times while reading it I wished the author had an economic historian coauthor.

C- The book was published in 1982. This means that the flow of the book segues from history to a current events commentary somtime around mid to late 1965. This is not a criticism just a reminder that with time the last hundred pages of the book may need revision.
10 people found this helpful
 Report