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Doody's Review ServiceReviewer: Judith Lee Kissell, PhD, MA, BA (Creighton University)
Description: The fourth edition of this book, and the first by this author, describes the various elements of healthcare in the United States as a system, and describes how each element is affected by the current changes in health finance and organization.
Purpose: The book is designed to give students and professionals who lack a background in health policy a broad understanding of the complexities of the United States health system and how it is changing under current financial and organizational pressures. Such an account is badly needed. The author does an excellent job of meeting his objectives.
Audience: The author aims this book at medical students and at practitioners who are not experts at health policy but who require broad understanding of the system. He succeeds in this goal.
Features: The author, a physician and professor of medicine at the State University of New York at Stony Brook, has written widely in the area of health policy and is well qualified to address this topic. The book contains two appendixes that provide a valuable list of reports on the healthcare system and suggestions for data sources.
Assessment: This is a valuable source for a broad overview of healthcare in the United States as a system. Its conciseness comprises some of its value as a tool for medical students whose time is limited, but who badly need this information. Perhaps its greatest value is that, because it focuses on healthcare as a system, it points to problems sometimes neglected in consideration of the changes occurring in healthcare. The author suggests, for instance, that attention be paid to the importance of public health and to how the structure of the healthcare system, which addresses acute illness and care, needs also to consider chronic illness and care. The change to managed care could, perhaps, be better clarified if he were to choose as a framework the notion of the integrated delivery system rather than managed care. Also, he mentions, but fails to elaborate upon, the differences between for profit and not-for-profit systems.