The question is: Why?

According to Jill Quadagno, a sociology professor at Florida State University, the answer lies in the successful campaigns of special-interest groups against national health insurance and the inability of reformers to muster large-scale public support for their ideas. The American Medical Association (AMA) torpedoed Truman’s proposal by labeling it "socialist medicine." In the 1990s, the Health Insurance Association of America (HIAA) helped sink President Bill Clinton’s efforts at health reform with its famous "Harry and Louise" advertisements, which capitalized on middle-class America’s fear of managed care.

The parallels here are not a coincidence, says Quadagno, whose book One Nation Uninsured: Why the U.S. Has No National Health Insurance describes in detail the history of America’s failed efforts to address its citizens’ health care needs. Quadagno wrote her book with support from a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

Ranging across the twentieth century, Quadagno’s book shows how powerful stakeholders, determined to keep health care financing out of the government’s hands, effectively attacked every attempt to enact national health insurance. "Whenever government action has seemed imminent, [special interests] have lobbied legislators, influenced elections by giving huge campaign contributions, and organized ‘grassroots’ protests, conspiring with other like-minded groups to defeat reform efforts," she writes.