In Grow and Hide, Colleen M. Grogan reveals America has never had a system that resembles a competitive, free-market model and argues that the public has been intentionally misled about the private sector and the extent of the government’s role. In what Grogan terms the “grow-and-hide regime,” the US created a publicly financed system--long before the passage of Medicare and Medicaid in 1965--while framing it as the opposite. Today, the state's role is larger than ever, yet it remains largely hidden because stakeholders—namely, private actors and their allies in government—have repeatedly, and successfully, presented the illusion of minimal government involvement. As Grogan shows, “private” and “public” are not real descriptors of the system but rather political frames for “good” and “bad.” The consequences of this narrative are scarce accountability and a highly unequal distribution of benefits. Given how much the government already invests, the distribution of these funds is a fundamental political question for the American public—not one that should be decided by the private sector. Before sweeping reform can ever fix America's broken health care system, we must have an honest discussion about the significant public investment buoying the private sector.
Colleen Grogan is the Deborah R. and Edgar D. Jannotta Professor at the University of Chicago in the Crown Family School of Social Work, Policy, and Practice. 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 currently Co-Principal Investigator of a large multi-institution NIH study to determine the effect of Medicaid Managed Care Organizations’ coverage on access to treatment and health outcomes for person with Opioid Use Disorder. Grogan is the Academic Director of the interdisciplinary Graduate Program on Health Administration & Policy (GPHAP) at the University of Chicago, and is the Deputy Dean for Curriculum in the Crown Family School of Social Work, Policy & Practice. She is an elected member of the National Academy of Social Insurance and served on its COVID-19 Policy Translation Task Force. She was Associate Editor of Health Policy for the American Journal of Public Health from 2017-2022, the Editor of the Journal of Health Politics, Policy & Law from 2010-2016, and President of the Health Policy & Politics Section of the American Political Science Association, from 2017-2018.