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In public discourse regarding health policy in Israel, one often hears that “we are on the road to America”. The concern underlying this cry is that the public–private mix in Israel, especially in terms of finance, is slowly wending its way towards the U.S. situation in which more than half of the national health expenditure comes from private sources. This is, of course, a somewhat skewed contention, as it disregards the fact that all Israeli residents are guaranteed a broad package of health entitlements, while in the U.S., fifteen percent of the population is uninsured. The attraction of simplistic, one-dimensional comparisons is great, especially in the heat of social debate. This tendency toward simplification exists not only in Israel, but also in the U.S. and other countries as well. It is good that parallel to this, a less strident and more considered discussion sometimes takes place among health policy analysts, providing understanding that, hopefully, takes its place in the maelstrom of the policy process. In the U.S. context, Stuart Altman and David Schactman have chosen to play this edifying role in Power, Politics, and Universal Health Care. In this fascinating and informative chronicle of U.S. health policy over the course of almost a century, Altman relies on his unique combination of academic grounding and continuous presence in the trenches of the battle for universal health insurance in America. Altman is a Brandeis University professor, and has served in many administrations and been involved as a task member in every health reform effort since 1970. Few, if any, observers, especially when teamed up with a knowledgeable and savvy co-author like Schactman, can give the reader both inside stories of how the policy process works, together with an analytical framework to mold the raw history into policyrelevant learning. It is an old adage that policy, like sausage, is a phenomenon regarding which it is perhaps better not to know the actual production process. Altman convincingly

Review essay: politics, power, and universal health care by Stuart Altman and David Schachtman