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An incisive look into the problematic relationships among medicine, politics, and business in America and their effects on the nation's health Meticulously tracing the dramatic conflicts both inside organized medicine and between the medical profession and the larger society over quality, equality, and economy in health care, Peter A. Swenson illuminates the history of American medical politics from the late nineteenth century to the present. This book chronicles the role of medical reformers in the progressive movement around the beginning of the twentieth century and the American Medical Association's dramatic turn to conservatism later. Addressing topics such as public health, medical education, pharmaceutical regulation, and health-care access, Swenson paints a disturbing picture of the entanglements of medicine, politics, and profit seeking that explain why the United States remains the only economically advanced democracy without universal health care. Swenson does, however, see a potentially brighter future as a vanguard of physicians push once again for progressive reforms and the adoption of inclusive, effective, and affordable practices

Meticulously tracing the dramatic conflicts both inside organized medicine and between the medical profession and the larger society over quality, equality, and economy in health care, Peter A. Swenson illuminates the history of American medical politics from the late nineteenth century to the present. This book chronicles the role of medical reformers in the progressive movement around the beginning of the twentieth century and the American Medical Association's dramatic turn to conservatism later. Addressing topics such as public health, medical education, pharmaceutical regulation, and health-care access, Swenson paints a disturbing picture of the entanglements of medicine, politics, and profit seeking that explain why the United States remains the only economically advanced democracy without universal health care. Swenson does, however, see a potentially brighter future as a vanguard of physicians push once again for progressive reforms and the adoption of inclusive, effective, and affordable practices.

Before addressing the commentators for their thoughtful input on "Misrepresented Interests," let me first thank the editors ofStudies in American Political Developmentfor providing a forum for an enduring debate about the power of capitalists in capitalist democracies like the United States. As a comparativist, I ventured into that complicated territory after extensive research in Sweden, where I discovered to my great surprise that the Social Democrat labor movement was kicking at open doors as it introduced each piece of Sweden's famous system of industrial relations and social insurance. Sweden's undeniably powerful employers stood contentedly aside and had no interest in closing the doors afterward. I was able to come to that conclusion with confidence only because the Swedish Employers' Confederation had allowed me extraordinary access to their entire archives, confidential minutes, internal and external correspondence, and the diaries of a former chief executive.

A belief that there is a pervasive and enduring adversarial relationship between business and the welfare state is shared widely across scholarly disciplines engaged in historical and comparative analysis of social politics. According to that view, each stage in the expansion of the American welfare state was a defeat for capitalists. Detailed evidence on the politics of health care, with special focus on the passage of Medicare in 1965, casts serious doubt on this dominant view about class politics, the welfare state, and the power of business. It shows that much of the literature takes a hazardous inferential leap from national business organizations' official positions against reform to overconfident conclusions about actual business opinions. The literature also mistakenly discounts evidence of business support for moderate reforms as strategic camouflage of actual opposition designed to head off more radical ones. Extensive evidence reveals enormous division within business rather than unity about the health care state, and a great deal of support from large and powerful corporations for its creation and expansion. Evidence about the economic implications of health insurance for businesses, including before and after Medicare, and all the way to the Affordable Care Act of 2010, indicates that the support was genuine, not strategic, and that sometimes it was critical for passage. That support calls for new thinking about how to answer the perennial question about class power in America: "Who actually governs?"

Public education is one of the most important "public goods" of a democratic society. In recent decades, public policy analysts, public intellectuals, and politicians have debated the state of public education in the United States and have argued about the sorts of public policies that might best promote the academic achievement, educational success, and political socialization of youth. Terry Moe and John Chubb have been important contributors to these debates. Their 1990 book, Politics, Markets, and America's Schools, set the terms of much subsequent discussion about the importance of school autonomy and "educational choice." Moe's Special Interest extends these arguments through a more frontal critique of the role of teachers unions. This book represents an important contribution to public discussion of school reform. It also incorporates a distinctive perspective on the relationship between power and public policy, and between the role of states and that of markets in the provision of public goods and services. In this symposium, we feature a range of serious commentaries on the book's central arguments about educational policy and politics and on its approach to "engaged" or "applied" political science.