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Power and Illness: The Failure and Future of American Health Policy

Daniel M Fox University of California Press, $20, pp 191 ISBN 0-520-08409-8

The theme of Daniel M Fox's study of American health care policy is simple but radical in its implications, and not just for the United States. It is that health care institutions are shaped by history - specifically by the inherited stock of ideas about the nature of the medical task - and that, in turn, these institutions then create interest groups which impede adaptation to new challenges. To put it more concretely, Professor Fox's argument is that the main health problem in the US, as elsewhere, is the management of chronic conditions …