"I am especially grateful for these nineteen essays . . . because they are so substantial. . . . This collection has proved to be neither a funeral pyre nor a festschrift [for The Social Transformation of American Medicine], and it has taught me much about the subject and the reception of my work that I did not know."
—Paul Starr, excerpted from his conclusion in "Transforming American Medicine: A Twenty-Year Retrospective on The Social Transformation of American Medicine"

Paul Starr’s Controversial Vision
In the early 1980s, as America stood at a crossroads—between New Deal liberalism and the conservatism of "the Reagan Revolution"—so too did American medicine and health care. Engaging this critical moment, Paul Starr’s The Social Transformation of American Medicine stimulated scholars across the disciplines to take stock of medicine’s historical and future trajectories. Starr’s analysis of American health care and medicine, undertaken in the context of broad contemporary societal, political, and cultural forces, earned him the Pulitzer and Bancroft Prizes, as well as garnering enduring public acclaim. Indeed, twenty years after its publication, The Social Transformation of American Medicine is now a standard in disciplines from health law to political science and history.

Despite its undeniable import, Starr’s book still provokes argument and strong reaction on all sides, and the question that has puzzled readers since the grand synthesis appeared remains: whether to praise or to criticize it. According to historian Keith Wailoo, health lawyer Timothy Stoltzfus Jost, and political economist Mark Schlesinger, coeditors of "Transforming American Medicine: A Twenty-Year Retrospective on The Social Transformation of American Medicine," a new special double issue of the Journal of Health Politics, Policy and Law, the answer appears to be to do both.

How Does the Vision Hold Up?
Rife with criticism, praise, and in-depth analysis of Starr’s work, this lengthy special issue brings together scholars from many disciplines to offer a comprehensive assessment of the life, the times, the promise, the problems, and the paradoxes of The Social Transformation of American Medicine. Contributors think critically about the problem of the grand narrative, about why doctors and health lawyers loved the book, about why historians reacted to it with ambivalence, about why its themes resonated as they did, and finally about how the political and policy landscape of health care has shifted in the last two decades. Additionally, the issue includes an extensive précis of salient parts of The Social Transformation of American Medicine and concludes with a contentious essay in which Starr himself responds to some of the criticism leveled at him in the preceding pages.

With American medicine and health care now at another crossroads—a relentless rise in medical spending on one side, and a persistent sense that Americans are not getting good value for their health care dollar on the other—the issues that Starr originally highlighted (the rise of medical authority and the elaborate dance among doctors, the state, and the corporation) are still of vital importance. "Transforming American Medicine: A Twenty-Year Retrospective on The Social Transformation of American Medicine" vigorously continues the discussion of medicine’s past, present, and future that Starr’s book set in motion.

Contributors. Gloria J. Bazzoli, Lawrence P. Casalino, Stefan Gildemeister, Michael S. Goldstein, Stefan Greß, Sydney A. Halpern, Clark C. Havighurst, Joel D. Howell, Timothy Stoltzfus Jost, Jennifer Klein, Theodore R. Marmor, Bernice A. Pescosolido, Jack K. Martin, Stephen S. Mick, Thomas R. Oliver, Jill Quadagno, Deborah A. Savage, Mark Schlesinger, Paul Starr, Keith Wailoo, John Harley Warner, Jürgen Wasem, William D. White

Table of contents and sample articles available for download!
View the issue's complete Table of Contents.

Read "Professional Sovereignty in a Changing Health Care System: Reflections on Paul Starr's The Social Transformation of American Medicine" by Keith Wailoo, Timothy Stoltzfus Jost, and Mark Schlesinger.

Review Theodore R. Marmor's "Comments on the Retrospective Issue".

  

  

  

  

Preliminary Perspectives
1. Professional Sovereignty in a Changing Health Care System: Reflections on Paul Starr’s The Social Transformation of American Medicine–Keith Wailoo, Timothy Stoltzfus Jost, and Mark Schlesinger

2. Comments on the Retrospective Issue–Theodore R. Marmor

3. Précis of Paul Starr’s The Social Transformation of American Medicine

Part 1. Before: Alternative Readings of the History of American Health Care
4. Open Moments and Surprise Endings: Historical Agency and the Workings of Narrative in The Social Transformation of American Medicine–Jennifer Klein

5. Sovereignty and Science: Revisiting the Role of Science in the Construction and Erosion of Medical Dominance–Keith Wailoo

6. Professional Sovereignty Revisited: The Network Transformation of American Medicine?–Deborah A. Savage

7. The Social Transformation of American Medicine: A Comparative View from Germany–Stefan Greß, Stefan Gildemeister, and Jürgen Wasem

8. Policy Entrepreneurship in the Social Transformation of American Medicine: The Rise of Managed Care and Managed Competition–Thomas R. Oliver

9. Cultural Authority and the Sovereignty of American Medicine: The Role of Networks, Class, and Community–Bernice A. Pescosolido and Jack K. Martin

Part 2. During: Reception and Impact
10. Grand Narrative and Its Discontents: Medical History and the Social Transformation of American Medicine–John Harley Warner

11. What the Doctors Read–Joel D. Howell

12. The Uses of The Social Transformation of American Medicine: The Case of Law–Timothy Stoltzfus Jost

Part 3. After: Prediction, Pluralism, and Policy Making, New Actors Emerge
13. Physician Sovereignty and the Purchasers’ Revolt–Jill Quadagno

14. Medical Authority and the Culture of Rights–Sydney A. Halpern

15. Reason, Rationalization, and Professionalism in the Era of Managed Care–William D. White

16. Shifting Roles for Existing Actors
Physicians and Corporations: A Corporate Transformation of American Medicine?–Lawrence P. Casalino

17. The Corporatization of American Hospitals–Gloria J. Bazzoli

18. The Physician “Surplus” and the Decline of Professional Dominance–Stephen S. Mick

19. The Reemergence of Dormant Themes
The Persistence and Resurgence of Medical Pluralism–Michael S. Goldstein–925

20. Starr on the Corporatization and Commodification of Health Care: The Sequel–Clark C. Havighurst

21. Reprivatizing the Public Household? Medical Care in the Context of American Public Values–Mark Schlesinger

22. Response
Social Transformation Twenty Years On–Paul Starr

23. Epilogue

24. News and Notes

25. News from Affiliated Organizations

26. Contributors