Stephen Shortell, one of the country's leading health care management authorities, and his team of experts use the most current data available to update their classic book Remaking Health Care in America. This expanded second edition includes a clear conceptual framework for health care leaders who must develop more integrative systems of care to meet the challenge of the evolving health care industry. The book also provides practical suggestions and myriad recommAndations for developing cost-effective delivery systems across the United States.
Stephen Shortell, one the country's leading health care management authorities, and his team of experts use the most current data available to update their classic book Remaking Health Care in America. This expanded second edition includes a clear conceptual framework for health care leaders who must develop more integrative systems of care to meet the challenge of the evolving health care industry. The book also provides practical suggestions and myriad recommendations for developing cost-effective delivery systems across the United States.
In a work that spans the twentieth century, Nancy Tomes questions the popular--and largely unexamined--idea that in order to get good health care, people must learn to shop for it. Remaking the American Patient explores the consequences of the consumer economy and American medicine having come of age at exactly the same time. Tracing the robust development of advertising, marketing, and public relations within the medical profession and the vast realm we now think of as "health care," Tomes considers what it means to be a "good" patient. As she shows, this history of the coevolution of medicine and consumer culture tells us much about our current predicament over health care in the United States. Understanding where the shopping model came from, why it was so long resisted in medicine, and why it finally triumphed in the late twentieth century helps explain why, despite striking changes that seem to empower patients, so many Americans remain unhappy and confused about their status as patients today.
In a compelling inquiry into public events ranging from the building of the Vietnam Veterans Memorial through ethnic community fairs to pioneer celebrations, John Bodnar explores the stories, ideas, and symbols behind American commemorations over the last century. Such forms of historical consciousness, he argues, do not necessarily preserve the past but rather address serious political matters in the present.--Publisher description.
Since the introduction of Medicare and Medicaid in 1965, the American health care system has steadily grown in size and complexity. Muriel R. Gillick takes readers on a narrative tour of American health care, incorporating the stories of older patients as they travel from the doctor's office to the hospital to the skilled nursing facility, and examining the influence of forces as diverse as pharmaceutical corporations, device manufacturers, and health insurance companies on their experience. A scholar who has practiced medicine for over thirty years, Gillick offers readers an informed and straightforward view of health care from the ground up, revealing that many crucial medical decisions are based not on what is best for the patient but rather on outside forces, sometimes to the detriment of patient health and quality of life. Gillick suggests a broadly imagined patient-centered reform of the health care system with Medicare as the engine of change, a transformation that would be mediated through accountability, cost-effectiveness, and culture change.
“Skillfully chronicles America’s struggles to make health care a right from the Depression through Obamacare. . . . beautifully written [and] compelling.” —Jonathan Oberlander, author of The Political Life of Medicare Named by Choice as an Outstanding Academic Title In Health Care for Some, Beatrix Hoffman offers an engaging, in-depth look at America’s long tradition of unequal access to health care. She argues that two main features have characterized the US health system: a refusal to adopt a right to care and a particularly American approach to the rationing of care. Health Care for Some shows that the haphazard way the US system allocates medical services—using income, race, region, insurance coverage, and many other factors—is a disorganized, illogical, and powerful form of rationing. And unlike rationing in most countries, which is intended to keep costs down, rationing in the United States has actually led to increased costs, resulting in the most expensive health care system in the world. While most histories of US health care emphasize failed policy reforms, Health Care for Some looks at the system from the ground up in order to examine how rationing is experienced by ordinary Americans and how experiences of rationing have led to claims for a right to health care. By taking this approach, Hoffman puts a much-needed human face on a topic that is too often dominated by talking heads. “A well-researched, readable primer on the development of the complex, fragmented US medical system.” —Times Higher Education
The American health care system is a unique mix of public and private programs that critics argue has produced a two-tier system - one for the rich and the other for the poor - that delivers dramatically unequal care and leaves millions of Americans seriously underinsured or with no coverage at all. This book examines the root causes of the inequalities of the American health care system and discusses various policy alternatives. It systematically documents the demands on and the performance of our health care system for different population groups as defined on the basis of gender (women), age (children), race and ethnicity (African Americans, Hispanics, Native Americans), and residence in high poverty areas (rural and inner city locales).For each population, the book documents: historical and demographic profile, data on health status, aspects of inequality including access; quality of care; and endemic, cultural, and lifestyle issues affecting health; policies, laws, and programs relevant to health care; and, indicators of improvement or negative trends.
Over the past three decades, the contours of American social, economic, and political life have changed dramatically. The post-war patterns of broadly distributed economic growth have given way to stark inequalities of income and wealth, the GOP and its allies have gained power and shifted U.S. politics rightward, and the role of government in the lives of Americans has changed fundamentally. Remaking America explores how these trends are related, investigating the complex interactions of economics, politics, and public policy. Remaking America explains how the broad restructuring of government policy has both reflected and propelled major shifts in the character of inequality and democracy in the United States. The contributors explore how recent political and policy changes affect not just the social standing of Americans but also the character of democratic citizenship in the United States today. Lawrence Jacobs shows how partisan politics, public opinion, and interest groups have shaped the evolution of Medicare, but also how Medicare itself restructured health politics in America. Kimberly Morgan explains how highly visible tax policies created an opportunity for conservatives to lead a grassroots tax revolt that ultimately eroded of the revenues needed for social-welfare programs. Deborah Stone explores how new policies have redefined participation in the labor force—as opposed to fulfilling family or civic obligations—as the central criterion of citizenship. Frances Fox Piven explains how low-income women remain creative and vital political actors in an era in which welfare programs increasingly subject them to stringent behavioral requirements and monitoring. Joshua Guetzkow and Bruce Western document the rise of mass incarceration in America and illuminate its unhealthy effects on state social-policy efforts and the civic status of African-American men. For many disadvantaged Americans who used to look to government as a source of opportunity and security, the state has become increasingly paternalistic and punitive. Far from standing alone, their experience reflects a broader set of political victories and policy revolutions that have fundamentally altered American democracy and society. Empirically grounded and theoretically informed, Remaking America connects the dots to provide insight into the remarkable social and political changes of the last three decades.
One of the most persistent puzzles in comparative public policy concerns the conditions under which discontinuous policy change occurs. In Remaking Policy, Carolyn Hughes Tuohy advances an ambitious new approach to understanding the relationship between political context and policy change. Focusing on health care policy, Tuohy argues for a more nuanced conception of the dynamics of policy change, one that makes two key distinctions regarding the opportunities for change and the magnitude of such changes. Four possible strategies emerge: large-scale and fast-paced ("big bang"), large-scale and slow-paced ("blueprint"), small-scale and rapid ("mosaic"), and small-scale and gradual ("incremental"). As Tuohy demonstrates, these strategies are determined not by political and institutional conditions themselves, but by the ways in which political actors, individually and collectively, read those conditions to assess their prospects for success in the present and over time. Drawing on interviews as well as primary and secondary accounts of ten health policy cases over seven decades (1945—2015) in the US, UK, the Netherlands, and Canada, Remaking Policy represents a major advance in understanding the scale and pace of change in health policy and beyond.
This revealing book tackles the daunting problem of increasing chronic illness in America, offering fresh ideas for the ways in which the challenge can be successfully managed. Remaking Chronic Care in the Age of Health Care Reform: Changes for Lower Cost, Higher Quality Treatment is nothing less than a blueprint for a new mode of chronic care. It depicts a current system in which there is little financial incentive to furnish coordinated services via appropriate primary care and few penalties for failure to deliver such care. Arguing that the current system is unsustainable, the book documents efforts that have been made to promote better coordination of care through patient-centered medical homes and accountable care organizations. Specifically, the book focuses on linking the ongoing innovations in health care practices with the supports for scaling up innovations found in the Patient Protection and Affordable Care Act. It shows how expanding and improving primary care as the vehicle for care coordination will reduce costs for those with conditions such as arthritis, diabetes, hypertension, or other longstanding disorders, but also makes it clear that incentives have to be realigned if such improved primary care is to become a reality.
