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Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Analyzes the problems of national health insurance, discusses the theory behind the president's proposal, and explains why it should work
The reform of American medical care is the most important topic on the nation's domestic agenda and the centerpiece of the Clinton administration's plans for social policy and long-term economic development. This book, written by a preeminent analyst of medical politics and policy who is a frequent adviser to Congress, helps to clarify the current debate over the President's bill and the proposed alternatives to it. It is essential reading. Theodore Marmor, whose work has appeared in the nation's major newspapers and magazines, as well as in scholarly journals and books, here presents some of his most recent writings that illuminate the historical, political, and economic considerations behind various proposals now under debate. Marmor explains what we can and cannot expect from reform of American medicine, and he addresses the many conflicting claims about remedies for America's problems with medical costs, quality of care, and access to treatment.
What is ‘good care’ and does more choice lead to better care? This innovative and compelling work investigates good care and argues that the often touted ideal of ‘patient choice’ will not improve healthcare in the ways hoped for by its advocates.
This valuable handbook makes the U.S. health care system understandable, reviews the Affordable Care Act (ACA) or "Obamacare," describes past health care reform efforts, and covers the important organizations and people involved in U.S. health care reform. Why does the United States produce poorer outcomes for Americans in terms of health care than most other developed countries that spend a lower percentage of their Gross Domestic Product (GDP) on health care? Should health insurance be private or should it be managed by the government? The second edition of Healthcare Reform in America: A Reference Handbook addresses these complex and difficult questions and many more in its thorough treatment of one of the most controversial issues in contemporary American discourse. The work provides a broad introduction to the history and key issues in the development and reform of the U.S. health care system. It then addresses the recent passage of the Affordable Care Act and the myriad of significant expected changes due to the Act, thereby providing readers with information essential to understanding the current issues regarding health care reform. This work serves as a valuable resource to high school and college students as well as to general readers wanting to learn about the history and current focus of health care reform in the United States.
Examines the complex interrelationships that inform the health care system. Health care, like all social systems, is a product of thought. Up to now, our collective thinking has been based on trying to manage parts, not the whole. This book inquires into four age-old questions that shape all health care systems: What is health? What is care? Who is responsible? How much is enough? Americans have the wealthiest health care system in the world, yet the health status of Americans ranks in the lowest quartile among the world's 25 industrialized nations and 45 million Americans are without health insurance. Today's cost, quality, and access problems are inter-related and can be traced to taken-for-granted assumptions and health care's outmoded organizing concepts: reductionism and materialism. Greater fragmentation of care, an over-dependence on technology, inattention to social and environmental determinants of health, and serious economic and moral dilemmas are some of the results of the last 40 years of piecemeal political and economic reform. This book has three purposes. The first is to help the reader see healthcare as a complex system—a part in a larger whole—and to show how answers to the questions, What is health? What is care? Who is responsible? How much is enough? implicitly define the purpose, effectiveness, efficiency, and fairness of a health care system. The second is to show that today's access, cost, and quality problems are interrelated, and arise from outmoded concepts, unquestioned assumptions, and a long trail of inconsistent and contradictory answers to the four questions. The third purpose is to acquaint readers with both the personal and societal challenges of finding coherent answers to the four questions raised above and to describe some of the budding experimental solutions that challenge traditional conventions and assumptions.
Recounts the history of health care policy in the United States, and argues that the country became entrapped through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change. Reprint.
Most of the current literature on healthcare operations management is focused on importing principles and methods from manufacturing. The evidence of success is scattered and nowhere near what has been achieved in other industries. This book develops the idea that the logic of production, and production systems in healthcare is significantly different. A line of thing that acknowledges the ingenious characteristics of health service production is developed. This book builds on a managerial segmentation of healthcare based on fundamental demand-supply constellations. Demand can be classified with the variables urgency, severity, and randomness. Supply is constrained by medical technology (accuracy of diagnostics, efficacy of therapies), patient health behavior (co-creation of health), and resource availability. Out of this emerge seven demand-supply-based operational types (DSO): prevention, emergencies, one-visit, electives, cure, care, and projects. Each of these have distinct managerial characteristics, such as time-perspective, level of co-creation, value proposition, revenue structure, productivity and other key performance indicators (KPI). The DSOs can be envisioned as platforms upon which clinical modules are attached. For example, any Emergency Department (ED) must be managed to deal with prioritization, time-windows, agitated patients, the necessity to save and stabilize, and variability in demand. Specific clinical assets and skill-sets are required for, say, massive trauma, strokes, cardiac events, or poisoning. While representing different specialties of clinical medicine they, when applied in the emergency – context, must conform to the demand-supply-based operating logic. A basic assumption in this book is that the perceived complexity of healthcare arises from the conflicting demands of the DSO and the clinical realms. The seven DSOs can neatly be juxtaposed on the much-used Business Model Canvas (BMC), which postulates the business model elements as value proposition; customer segments, channels and relations; key activities, resources and partners; the cost structure; and the revenue model.
The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.