Paul Starr

Paul Starr Paul Starr is co-founder and co-editor of the The American Prospect. and professor of sociology and public affairs at Princeton University. A winner of the Pulitzer Prize for General Nonfiction and the Bancroft Prize in American history, he is the author of seven books, including most recently Remedy and Reaction: The Peculiar American Struggle over Heath Care Reform (Yale University Press, revised ed. 2013). Click here to read more about Starr.

Recent Articles

The Preventive Turn in Health-Care Reform

Promoting preventive care and public health carries both promise and risk.

When health insurance developed in the United States in the 1930s, it covered hospital and later major medical bills, not preventive services. Insurance also had nothing to do with public health. And when Medicare was enacted in 1965, it too made no provision for preventive and public-health services. The Affordable Care Act is different. Culminating a long shift in thinking, it incorporates preventive care into health insurance and seeks to promote public health through provisions aimed at reducing obesity and smoking and encouraging participation in wellness programs. The changes in insurance coverage are straightforward to implement. New private insurance policies -- that is, all but "grandfathered" plans in existence at the time the president signed the law on March 23 -- will have to cover 100 percent of the cost of a list of preventive services that have met standards for effectiveness set by the U.S. Preventive Services Task Force. (Clinical preventive services include...

The Next Health-Reform Campaign

Supporters of reform knew they had to battle to get it passed. Now they need to wage another campaign to implement it.

Ron Pollack, Founding Executive Director of Families USA. (Flickr/House Committee on Education and Labor)
( Por la versión en español, haga clic aquí ) Carrying out health-care reform presents challenges far beyond those of ordinary legislation or even such landmarks as Social Security and Medicare. After a law establishes a new program, the next steps are usually a bureaucratic process of policy implementation. But the legislation passed by Congress last March, the Patient Protection and Affordable Care Act, will need to run a gauntlet of treacherous hurdles and be politically implemented. The reforms will have to be defended in two national elections because the major provisions don't go into effect until January 2014. Assuming the law survives national efforts to reverse it, its implementation will also depend on complementary action in all 50 states, including many where Republican leaders have been hostile to the changes, questioned their constitutionality, and enacted measures to nullify the federal reforms. Although the federal courts are unlikely to uphold these challenges, the...

A 20-Year Tug-of-War

Neither liberals nor conservatives have been able to claim lasting power. But we have an advantage: real solutions.

President-elect Bush meets with Vice President Al Gore, Dec. 19, 2000. (AP Photo/J. Scott Applewhite)
It's months before the November elections, and Republicans have practically broken out the champagne to celebrate their coming victories, while many liberals are chalking up prospective losses to the failure of the president and congressional Democrats to be ambitious enough. Excuse me if I don't join in the "precriminations." The elections may turn out badly, but the achievements of the administration's first year and a half have been more than respectable, and I doubt that more progressive policies could have borne fruit quickly enough to alter the results in November. Nor do I believe that Democrats have overreached, only to suffer the predictable reaction from a "center right" society. If the economy were growing smartly, the conservative complaints about too much government would have little resonance. But the facts are what they are. Most Americans have felt the impact of the recession only since Barack Obama took office, and though they can't hold him responsible for the...

Better Than Tea

Let the Republicans drink the Tea Party's brew. Progressives shouldn't wish for the equivalent.

Something feels wrong about the state of American politics. With millions unemployed and home foreclosures at record levels, the country is still suffering acutely from the recession's effects, yet the Tea Party is the only movement that can put thousands of people into the streets. How is it that so soon after activists helped Barack Obama win the presidency, the left is quiet while feet march and fires burn on the right? Many progressives blame Obama, saying that he fell in with the wrong crowd in Washington and Wall Street, gave too much ground on policy, failed to mobilize his grass-roots organization, and lost his true voice, at least until the final weeks of the health-care battle when he barnstormed the nation and looked like the candidate the public elected in 2008. Envious of the Tea Party's angry crowds, even saying they sympathize with them, these progressives yearn for Democrats to express that same populist anger -- but to direct it against the big banks and other...

The Opt-Out Compromise

How to let individuals out of the insurance mandate and improve the odds of health-care reform.

President Barack Obama at Arcadia University in Glenside, Pa., Monday, March 8, 2010. (AP Photo/Charles Dharapak)
If the House of Representatives passes the Senate health-care reform bill with the changes recommended by President Barack Obama, and the Senate then passes those final changes through reconciliation, no one will be more pleased than I (see " Underrating Reform " in the Prospect 's March issue). But suppose that after the White House and congressional leadership press their case, twist arms, and count heads, they are still short of the votes they need. Should they just give up on the legislation, or can they make any additional concession to attract votes while preserving the aims of reform? Last Thursday, in an op-ed in The New York Times that built on a November article in the Prospect , I proposed a change that may help gain the votes of some conservative Democrats and assuage the concerns of many Americans who object in principle, or out of fear, to a federal health-insurance mandate. My proposal would enable a congressman to say to constituents angry about the federal mandate, "...

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