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Medical Necessity: Health Care Access and the Politics of Decision Making, Daniel Skinner

Reviewed by Simon F. Haeder

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Health and health policy have played a dominant role in American politics at least since the debates surrounding the passage of the Affordable Care Act (ACA), and thus well before the emergence of the novel coronavirus and COVID-19 that have come to control our daily lives. Unsurprisingly, political scientists have written amply about the subject. However, they have mostly focused on such “big” topics as the ACA’s Medicaid expansion and insurance marketplaces, the policy feedback effects of these policies, and political framing. Daniel Skinner’s book Medical Necessity: Health Care Access and the Politics of Decision Making adds important nuance to the health policy and political science literatures and reminds us that, as in real life, the devil is often in the details—and, of course, that politics reaches deep into seemingly technocratic decisions that govern our daily lives.

Medical Necessity provides an interesting account of how a “curious concept” (p. 1), ubiquitous yet largely out of the limelight, emerged and evolved over the years to become highly contested, with direct and often significant implications for how Americans can or cannot access medical care. Skinner begins by reaching out to thinkers such as Michel Foucault, Ludwig Wittgenstein, and Jacques Der

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