An Introduction to the US Health Care System: Sixth Edition / Edition 6

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Completely expanded and updated to account for the latest changes in the U.S. health care system, this best-selling text remains the most concise and balanced introduction to the domestic health care system. Like its predecessors, it provides an accessible overview of the basic components of the system: healthcare personnel, hospitals and other institutions, the federal government, financing and payment mechanisms, and managed care. Finally, it provides an insightful look at the prospects for health care reform.

Steven Jonas, a revered expert in public health, has enlisted his colleagues, Drs. Raymond and Karen Goldsteen, to add their expertise in public health and health policy and management to this outstanding volume. All students of health care administration and policy, as well as practicing healthcare professionals who simply want a relatively brief overview of the system, will find it useful.

The book contains no figures.

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Editorial Reviews

Judith Lee Kissell
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. 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. 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. 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. 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 toconsider 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.
From The Critics
Reviewer: Judith Lee Kissell, PhD, MA, BA (Creighton University)
Description: This book gives an overall view of the U.S. healthcare system, emphasizing its uniqueness in relationship to other systems worldwide. It is written at a level for students, is easily grasped, and includes most, if not all, of the important factors that describe the U.S. system.
Purpose: The author intends to provide a thorough and accessible book for undergraduate students. As such, it is an easily accessible source of information on the healthcare system for the lay reader as well as for undergraduate students.
Audience: The book is addressed to undergraduate students, according to the author, but it is also accessible to graduate and professional healthcare students as well as to the lay reader. The author acknowledges the bias he presents in his material, does a thorough job, and is a credible authority.
Features: The book discusses several aspects of the U.S. healthcare system, including issues such as planning, clinical and institutional problems, financing, education, etc., and points out those areas in which the U.S. system differs from other systems throughout the developed world. The book is particularly effective in making the point that the purpose of healthcare "should be to meet and serve the health care needs of the American people." It is also effective in providing an historical perspective of the issues it covers. Because it is intended for undergraduate students, the book is limited in the amount of material it covers and the depth to which it is covered.
Assessment: The book is a good source of basic information that is well-written, easy to read, and a quick study. It is useful for clinicians and other healthcare professionals who need to know the basics of the healthcare system in a hurry. The book is written from the perspective of providing healthcare to people who need it because they need it, rather than from a profit motive:an approach that should be at the heart of professionalism in medicine.
APHA Health Administration Newsletter
This is a brief, easy-to-read volume which is an ideal text for medical and nursing students who require a basic understanding of American health services, without a detailed exploration of their complexities.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780826102140
  • Publisher: Springer Publishing Company, Incorporated
  • Publication date: 5/25/2007
  • Edition description: Sixth Edition
  • Edition number: 6
  • Pages: 328
  • Product dimensions: 6.62 (w) x 8.92 (h) x 0.73 (d)

Meet the Author

Steven Jonas, MD, MPH, MS, is Professor of Preventive Medicine, School of Medicine, and Professor, Graduate Program in Public Health, at Stony Brook University (NY). He is a Fellow of the New York Academy of Sciences, the American College of Preventive Medicine, the New York Academy of Medicine, and the American Public Health Association. In 2006, he received the Duncan Clark Award for lifetime achievement granted by the Association for Prevention Teaching and Research (formerly the Association of Teachers of Preventive Medicine). He is Editor-in-Chief of the American Medical Athletics Association Journal and a member of the Editorial Board of ACSM's Health and Fitness Journal.

Over the course of an academic career that began in 1969, his research has focused on health care delivery systems analysis, preventive medicine and public health, and personal health and wellness. He has authored, co-authored, edited, and co-edited over 25 books, and published more than 135 papers in scientific journals, as well as numerous articles in the popular literature. He is and has been a regular columnist for a number of scientific and lay publications in the health and health-related arenas and also publishes regularly on several webmagazines on the subject of politics. It was in the mid-70s that, having been given the opportunity to do so by Dr. Ursula Springer, he created Health Care Delivery in the United States. He was actively involved with the first seven editions of that book. He is very proud that his name will be continue to associated down through time with that book, as it will be with this one, as it moves on to future editions under the able stewardship of the Drs. Goldsteen.

Raymond Goldsteen
, DrPH, is Director, MPH Program and Professor, Department of Family and Community Medicine, School of Medicine and Health Sciences,
University of North Dakota. He was founding Director of the Graduate Program in Public Health and Professor of Preventive Medicine in the School of
Medicine at SUNY Stony Brook. Dr. Goldsteen has an extensive background in health care and was formerly a director of the health policy research centers at the University of Illinois in Urbana-Champaign, University of Oklahoma College of Public Health, and the West Virginia University School of Medicine. He is co-author of the first edition of Introduction to Public Health and the highly acclaimed An Introduction to the U.S. Healthcare System,
now in its seventh edition.

Karen Goldsteen
, PhD, is Research Associate Professor, Department of Family and Community Medicine, MPH Program, University of North Dakota. She was
Professor of Health Technology and Management in the Graduate Program in Public Health at the SUNY in Stony Brook, NY. She was a Pew Health Policy Fellow at the University of California, San Francisco. Dr. Goldsteen is co-author of the first edition of Introduction to Public Health and the highly acclaimed An Introduction to the U.S. Healthcare System, now in its seventh edition.

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Read an Excerpt

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Table of Contents

Foreword to the Sixth Edition

Preface to the Sixth Edition

• Introduction

Health and Health Care

Health Care Systems

U.S. Health Care System

Future of the U.S. Health Care System

• Health Care Workforce




Physicians Assistants

Health Care Workforce Outside the Hospital and Physician Office


• Hospitals and Other Health Care Institutions



Hospital Structure

Public General Hospitals

The Hospital in the Present Era

Long-Term Care: The Example of Nursing Homes

• Primary and Ambulatory Care

Primary Care

Ambulatory Care


• Government and the Health Care System


Some History

The Constitutional Basis of Government Authority in Health Care

The Health Care Functions of Government

The Federal Government and the Provision of Health Services

State Governments' Role in Health Services

Local Governments' Role in Health Services

Problems in Public Health


• Financing and Payment of Health Care


How Much is Spent

Where the Money Comes From, Within the System

Where the Money Goes

How the Money is Paid Out: Providers, Payers, and Payments


• Health Care System Performance


Quality of Health Care

Equity of Health Care

Efficiency of Health Care

A National Scorecard

Data and Information Technology


• From Prepaid Group Medical Practice to Managed Care


Medical Group Practice

Health Maintenance Organizations

Managed Care

Integrated Delivery Systems

Managed Care Today

Some Policy Issues in Managed Care

• Health Care Reform


History of Change

National Health Insurance (NHI)

Some Contemporary Approaches to NHI

Looking Ahead



Appendix I List of Critical Reports

Appendix II Sources of Data

Appendix III Glossary of Terms

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This new edition portrays the 'system as a whole,' complicated but still described and analyzed as a total organism. With the sophistication and clarity of Dr.Stevn Jonas, this account manages to encompass all the diverse components of the American health system in a relatively short volume. It paints a picture with the necessary highlights and shadows, yet on a canvas with a relatively small frame.
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