Grow and Hide: The History of America’s Health Care State

Grow and Hide: The History of America’s Health Care State

Grow and Hide: The History of America’s Health Care State

The UCLA Center for Health Policy Research presents Grow and Hide: A Book Talk and Conversation with Colleen M. Grogan.

For more than 160 years, federal, state, and local governments in the United States have invested heavily in public health and health care services. Yet throughout history, our taxpayer-supported health care architecture has remained mostly hidden to the American public behind the veneer of a predominantly private system. How did this happen?

Colleen Grogan, PhD, renowned expert on the U.S. health care system, will share answers from her new book Grow and Hide: The History of America’s Health Care State. Grogan’s sweeping history of the American health care state explains how and why the grow-and-hide phenomenon arose from 1866 to 1965, and details the consequences we’ve all felt from 1965 to the present. 

Grogan argues that a combination of factors allowed the grow-and-hide regime to take root. Patronage politics, contracting with nonprofits, and administering health care among multiple agencies at all levels of government essentially hid the extent of government involvement and shaped a national discourse that perpetuated the myth of a predominantly private system.

The consequences for the American public are an expensive system that encourages profiteering and fails to hold the private sector accountable. It’s also an inequitable system with inconsistent transparency that reveals public funding for poor and stigmatized groups, while hiding public subsidies for middle- and upper-income Americans. 

The book talk will be followed by a conversation with UCLA Center for Health Policy Research Senior Fellow Mark Peterson, PhD.

About the presenters:

  • Dr. Colleen M. Grogan is the Deborah R. and Edgar D. Jannotta Professor at the University of Chicago. Grogan's research focuses on health policy and politics with a primary focus on the US health care system and its complex entitlement programs. She is the author of Healthy Voices/ Unhealthy Silence: Advocacy and Health Policy for the Poor and numerous articles that focus on elite decision-making around America's Medicaid program and offer a fundamentally new way to view the politics of the program. She is an elected member of the National Academy of Social Insurance and served on its COVID-19 Policy Translation Task Force. Grogan's work has been covered by The Washington Post, NPR, and The Guardian.
  • Dr. Mark A. Peterson is a Senior Fellow at the UCLA Center for Health Policy Research and a Professor of Public Policy, Political Science, and Law at the UCLA Luskin School of Public Affairs, UCLA College, and UCLA School of Law. Peterson specializes in American national institutions and the federal government, and the interactions between the roles of the Presidency, Congress, and interest groups in creating public policy — both nationwide and in domestic settings. His policy expertise spans far and wide, covering national health care policy, Medicare reform, and HIV/AIDS politics and policy. Peterson also studies the role of research evidence in policymaking, including the contextual factors that promote or inhibit its influence.  He was a founding team member of the UCLA-based multidisciplinary Blue Sky Health Initiative to transform the U.S. health and health care system, which advised Congress and the executive branch on the inclusion of population health strategies in the Affordable Care Act.