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Reforming health care, revamping the welfare system, preserving or cutting Social Security, creating employment programmes for displaced employees, and revising US social programmes to help working parents with children - all of these endeavours and more are part of ongoing national debates about the future of social policy in the United States. In this wide-ranging collection of essays, social scientist Theda Skocpol shows how historical understanding, centred on US governmental institutions and shifting political alliances, can illuminate the limits and possibilities of American social policy-making, both past and present. The author dispels the myth that Americans are inherently hostile to governmental social spending. When universal social programmes jointly benefit the middle class and the poor, she shows, Americans since the 19th century have been willing to pay taxes for them and happy to partake of the security they provide. Insights from the past also illuminate why ideological attacks against "bureaucratic meddling" by the federal government repeatedly prove so potent in US politics. Skocpol suggests why President Clinton's proposals for comprehensive health care reforms were so quickly attacked, even though Americans agree that the health financing system is in crisis and support universal insurance coverage.