{'fraction_non_alphanumeric': 0.016362492133417242, 'fraction_numerical': 0.003775959723096287, 'mean_word_length': 5.597510373443983, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
The Social Transformation of American Medicine: A Comparative View from Germany

In The Social Transformation of American Medicine (1982), Paul Starr argues that physicians in the United States exercise authority over patients, fellow workers in health care, and even the public at large. This authority spills over its clinical boundaries into arenas of political action for which medical knowledge is only partly relevant. According to Starr, the medical profession has been able to turn its authority into social privilege, economic power, and political influence. Hardly anywhere have doctors been as successful as American physicians in resisting national insurance and maintaining a predominantly private and voluntary financing system. Physicians in the United States have not only escaped from corporate and bureaucratic control in their practices, they also have been able to channel the development of hospitals, health insurance, and other medical institutions into forms that did not intrude upon their autonomy (5– 6). The enactment of compulsory social health insurance legislation in other Western capitalist countries suggests there was no fundamental reason that the United States could not also have adopted social health insurance. However, Starr argues, the medical profession was one of the main opponents of compulsory social health insurance. No powerful coordinating authority was permitted to emerge, because it would have threatened professional autonomy and physician control of the market. Even though universal health insurance would have boosted the income of