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The Shadow Welfare State
Labor, Business, and the Politics of Health Care in the United States
Marie Gottschalk (Author)
9780801437458
Hardback, published 12 June 2000
304 pages
22.9 x 15.2 x 2.7 cm, 0.907 kg
An explosively important book.... Marie Gottschalk's marvelous book... relieves us of the need to conjecture and hypothesize in trying to make sense of the little that we really knew of what was going on at the highest levels of the AFL-CIO ten years ago. She lifts the veil and at last we can all understand—and share in—the anger of those courageous union leaders within the federation who steadfastly stood firm for a universal, single-payer system of health care.... The working rank-and-file will ignore this book at their own peril. Gottschalk has written an incisive analysis of the failure of President Clinton's health reform proposal... Her account provides superior perspective on the debacle, because it roots the debate about employment-based health insurance plans in developments in labor-management relations and in the accommodation of leading Democrats to the business agenda that surged to the fore in the 1970s and 1980s. The book is written with verve and theoretical sophistication. Gottschalk provides a thorough analysis of the political climate in which organized labor must operate. In The Shadow Welfare State, Marie Gottschalk recounts labor's half century-long fight for decent health care coverage through both collective bargaining and political action. More than most writers, she brings these two sides of the coin together to analyze both the fragility of the private welfare state, even for those who are covered by it, and the closely related political weakness of labor in the U.S. Several solid studies of the failure of the Clinton health reform campaign of the early '90s attempt to assess the role of all the key players. Gottschalk, a University of Pennsylvania political scientist, focuses on the interaction of labor and business in that debate.... A cogent, provocative analysis of a particular battle that also raises larger questions for the future. This very well written and engaging book touches myriad issues in the history of labor, social democracy, and American political institutions.... All labor scholars will find her book a rich source of analysis and information on a wide variety of topics.
Why, in the recent campaigns for universal health care, did organized labor maintain its support of employer-mandated insurance? Did labor's weakened condition prevent it from endorsing national health insurance? Marie Gottschalk demonstrates here that the unions' surprising stance was a consequence of the peculiarly private nature of social policy in the United States. Her book combines a much-needed account of labor's important role in determining health care policy with a bold and incisive analysis of the American welfare state. Gottschalk stresses that, in the United States, the social welfare system is anchored in the private sector but backed by government policy. As a result, the private sector is a key political battlefield where business, labor, the state, and employees hotly contest matters such as health care. She maintains that the shadow welfare state of job-based benefits shaped the manner in which labor defined its policy interests and strategies. As evidence, Gottschalk examines the influence of the Taft-Hartley health and welfare funds, the Employee Retirement Income Security Act (E.R.I.S.A.), and experience-rated health insurance, showing how they constrained labor from supporting universal health care. Labor, Gottschalk asserts, missed an important opportunity to develop a broader progressive agenda. She challenges the movement to establish a position on health care that addresses the growing ranks of Americans without insurance, the restructuring of the U.S. economy, and the political travails of the unions themselves.