Health care history through humor

"Political cartoons cut to the essence of our battle over who should foot the bill for medical coverage and how that care should be structured," explains Theodore Brown, one the four authors of The Quest for Health Care Reform: A Satirical History due out in October 2012. "But unlike the pain involved in our political struggle, cartoons deliver their uncomfortable truths with such irreverent wit and visual imagination that you can't help but chuckle."

Brown, a historian of medicine, public health, and health policy at the University of Rochester, provides the historical context for each cartoon and authored introductory chapters on early health care reform efforts. He says the book's broad sweep helps to bring into focus many of the themes and political patterns that surface over and over throughout the decades. The "political use of fear, hope, selective memory, and outright distortion will be seen as running threads in our health reform history," he writes in the book's preface.

From the first decades of the 20th century, critics sought to brand universal medical coverage as "un-American" and "socialistic." Government health care was derided as "Germanic" after World War I, as revolutionary following the Russian Revolution (1917), and as a subversive plot engineered by the Kremlin during the McCarthy era. Long before accusations about "death panels" surfaced during the 2009 debate, opponents decried federal financed medical insurance as "state medicine" and as early as the 1920s the American Medical Association characterized any government plan as "robotic."

While many of the overarching themes have remained the same, the complexity of the nation's health delivery system and the number and financial power of special interests has mushroomed in recent decades, says Brown. From pharmaceutical and insurance lobbies to hospitals, physicians, and patient rights groups, the debate has grown more complex and confusing for the public.

It is precisely in this cacophony of competing perspectives that political cartoonists have offered some of our most brilliant social commentary, says coauthor Susan Ladwig, a public health professional at the University of Rochester Medical Center. Ladwig selected many of the cartoons for the history and has collaborated with Brown for years on presentations about the history of health care. Using visual metaphors, like depicting the public as a sick patient or the health care system as an overly complicated machine, these artist are able to home in on the underlying truths and self-interests that can otherwise be lost in daily news coverage, she explains.

"The book makes the whole complex topic of health care more accessible, even fun," says Ladwig. "Hopefully people are going to want to read this history. I hope they don't just skip over the narrative, but even if they just view the cartoons, they will come away with a better understanding of heath care reform. It may even change a few people's minds when they know the whole story."

The book brings together the work of more than 27 cartoonists, including 10 winners of the Pulitzer Prize for editorial cartooning. Almost a fifth of the selections are the creation of Matt Wuerker, winner of the 2012 Pulitzer Prize for editorial cartooning and a finalist for the award in 2010 and 2009. A founding staffer at Politico, Wuerker is known for lampooning partisan conflict in Washington. Other Pulitzer winners represented in the book include Mike Luckovich (2006, 1995), Nick Anderson (2005), Clay Bennett (2002), and Joel Pett (2000).

The Political Cartoon History of Health Care Reform is the brainchild of Georges Benjamin, executive director of the American Public Health Association, whose collection of close to 1,000 cartoons on health care laid the basis for the project. Coauthor Elyse Berkman, a graduate student in health policy at City University of New York, assisted with research.

View a video and slideshow from the book at http://www.rochester.edu/news/show.php?id=4732.

Published by the American Public Health Association, the 212-page paperback can be ordered online at http://www.aphabookstore.org.