front cover of Broken Promise
Broken Promise
The Subversion Of U.S. Labor Relations
James A. Gross
Temple University Press, 2003
The Wagner Act of 1935 (later the Wagner-Taft-Hartley Act of 1947) was intended to democratize vast numbers of American workplaces: the federal government was to encourage worker organization and the substitution of collective bargaining for employers' unilateral determination of vital work-place matters. Yet this system of industrial democracy was never realized; the promise was "broken." In this rare inside look at the process of government regulation over the last forty-five years, James A. Gross analyzes why the promise of the policy was never fulfilled. Gross looks at how the National Labor Relations Board's (NLRB) policy-making has been influenced by the President, the Congress, the Supreme Court, public opinion, resistance by organized employers, the political and economic strategies of organized labor, and the ideological dispositions of NLRB appointees. This book provides the historical perspective needed for a reevaluation of national labor policy. It delineates where we are now, how we got here, and what fundamental questions must be addressed if policy-makers are to make changes consistent with the underlying principles of democracy.
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front cover of More than Medicine
More than Medicine
The Broken Promise of American Health
Robert M. Kaplan
Harvard University Press, 2019

Stanford’s pioneering behavioral scientist draws on a lifetime of research and experience guiding the NIH to make the case that America needs to radically rethink its approach to health care if it wants to stop overspending and overprescribing and improve people’s lives.

American science produces the best—and most expensive—medical treatments in the world. Yet U.S. citizens lag behind their global peers in life expectancy and quality of life. Robert Kaplan brings together extensive data to make the case that health care priorities in the United States are sorely misplaced. America’s medical system is invested in attacking disease, but not in addressing the social, behavioral, and environmental problems that engender disease in the first place. Medicine is important, but many Americans act as though it were all important.

The United States stakes much of its health funding on the promise of high-tech diagnostics and miracle treatments, while ignoring strong evidence that many of the most significant pathways to health are nonmedical. Americans spend millions on drugs for high cholesterol, which increase life expectancy by only six to eight months on average. But they underfund education, which might extend life expectancy by as much as twelve years. Wars on infectious disease have paid off, but clinical trials for chronic conditions—costing billions—rarely confirm that new treatments extend life. Meanwhile, the National Institutes of Health spends just 3 percent of its budget on research on the social and behavioral determinants of health, even though these factors account for 50 percent of premature deaths.

America’s failure to take prevention seriously costs lives. More than Medicine argues that we need a shakeup in how we invest resources, and it offers a bold new vision for longer, healthier living.

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