“When Barack Obama entered the White House in January of 2009, it seemed as if the stars were aligned and the timing was propitious for the United States to establish a new national health care system. Obama had made health care reform a central pillar of his presidential campaign and […] nearly 80 percent of voters wanted substantial changes to the U.S. medical system. In fact, though, the new president’s health care proposals prompted ferocious national debate and finally squeaked through Congress without a single vote to spare.” 

Reid illustrates the great hope that the election of Barack Obama would finally mean that the US would get a functioning health care system on par with that of other industrialized nations. President Obama had the public on his side, but the tide shifted in favor of his political opponents, causing the legislation that he did pass—not universal health care—to offer less than what the electorate needs. In this quote, we see how political factors have impeded health care reform. 

“The thesis of this book is that we can find cost-effective ways to cover every American by borrowing ideas from foreign models of health care […] But many Americans intensely dislike the idea that we might learn useful policy ideas from other countries, particularly in medicine.” 

Reid explains the purpose behind his writing the book. He acknowledges how the notion of American exceptionalism impedes the nation from making better decisions about health care.

“In U.S. policy debates, the term ‘socialized medicine’ has been a powerful political weapon—even though nobody can quite define what it means. The term was popularized by a public relations firm working for the American Medical Association in 1947 to disparage President Truman’s proposal for a national health care system. It was a label, at the dawn of the cold war, meant to suggest that anybody advocating universal access to health care must be a communist. And the phrase has retained its political power for six decades.” 

Much of the aversion to universal health care is rooted in propaganda that plays on fears that a systemic change will undermine American free market values. What many Americans do not know, which Reid later explains, is that, in some other countries with universal health care—particularly Germany—patients still have access to any plan they choose and select their own doctors. Meanwhile, medical providers can maintain private practices. The long-standing fears are, therefore, unfounded.