Why Doesn’t the United States Have National Health Insurance? The Political Role of the American Medical Association

The authors would like to thank Corey Purcell from the Harvard Medical School Countway Library, Jorie Braunold and Kelsey Walsh from the American Medical Association Archives, Kim Garber from the American Hospital Association Archives, Beth Benham from the State Archives of the State of California, and Adam Berenbak from the National Archives in D.C., for their generous assistance in accessing many of the historical resources used in this work. We thank seminar participants at NBER Economics of Culture and Institutions, NBER Development of the American Economy, NBER Economics of Health, NBER Economics of Aging, Cleveland Clinic, Clark University, Duke University, Johns Hopkins University, Harvard Medical School, University of Kentucky, University of Southern California, New York University, Columbia School of Public Health, University of British Columbia, Brown University Population Studies, London School of Economics, Harvard Kennedy School, Northwestern University, Harvard Economic History, University of California Berkeley, University of California Davis, the University of Copenhagen, the Massachusetts Medical Society Committee on Women’s Health and the Women Physicians Section, University of Bergen, University of Gothenburg, and the University of Hamburg, for helpful comments. We thank the editor Nathan Nunn, co-editor Larry Katz and five anonymous referees for comments that substantially improved the manuscript. We also thank Amitabh Chandra, David Cutler, Melissa Dell, Maya Durvasula, Amy Finkelstein, Price Fishback, Raymond Fisman, Paola Giuliano, Edward Glaeser, Grant Goehring, Claudia Goldin, Andrew Goodman-Bacon, Jonathan Gruber, Eric Hilt, Peter Hull, Asim Khwaja, Eliana La Ferrara, Gary Libecap, Matt Notowidigdo, Eric Patashnik, Joshua Schwartzstein, Mark Shepard, Jon Skinner, Marco Tabellini, and Marcos Vera-Hernandez for additional comments. Aydin Alsan, Nicolas Bastias Campos, Myra Bhathena, Duncan Beecroft, Luis Cardenas, Alexy Carolan, Anne Fogarty, Moritz Heck, Vanessa Jia, Nitika Johri, Natalie Jones, Bella Kong, Jeongmook Lim, Michelle Lin, Bhavya Pandey, Maya Rosen, Michelle Wu, Anna Volpp, and Xingyou Ye provided excellent research assistance. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

• May 17, 2024
• September 17, 2024
• July 17, 2025