Description: This relatively brief book provides a surprisingly comprehensive overview of the U.S. healthcare system; the previous edition was published 1998.
Purpose: The authors' stated purpose is to "explain how the health care system works." focusing on basic principles of healthcare policy and emphasizing comparisons with other systems as well as opportunities for change in our own.
Audience: The stated audience is health science students (e.g., medical, nursing, physician assistant, pharmacy, public health).
Features: In 19 chapters ranging from "Paying for Health Care" to "Mechanisms for Controlling Cost" to "The Quality of Health Care," the authors skillfully use clinical vignettes, administrative case studies, historical examples, and illustrations to describe the U.S. healthcare system. Most vignettes work well as accurate and illustrative archetypes of real world situations. A few are oversimplified from the practitioner's viewpoint, but likely serve adequately in their chief application of teaching health sciences students. The section on quality of care lacks substantive discussion of medical errors and patient safety initiatives.
Assessment: This is generally an excellent book, filled with interesting information not only for the student, but for the experienced practitioner and administrator as well. Given the rapid changes in the U.S. healthcare system since 1998, this third edition is well justified. The book was originally conceived and written during an era when many health policy experts expected U.S. healthcare to be reorganized into integrated care delivery systems financed by capitation; nonetheless, in chapter 16 the authors acknowledge the recent national divergence in strategies and review implications for the future.