An Introduction to the US Health Care System

by Steven Jonas MD, MPH, FACPM, Raymond L. Goldsteen DrPH, Karen Goldsteen PhD, MPH

Overview

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.

Product Details

ISBN-13:	9780826103154
Publisher:	Springer Publishing Company
Publication date:	05/25/2007
Sold by:	Barnes & Noble
Format:	eBook
Pages:	328
File size:	2 MB

About 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).

Raymond L. Goldsteen, DrPH, is professor emeritus of Family, Population&Preventive Medicine, at the Health Sciences Center, Stony Brook University, where he was founding director of the Master of Public Health (MPH) program.

Karen Goldsteen, PhD, MPH, is affiliated research associate professor of Family, Population&Preventive Medicine at the Health Sciences Center, Stony Brook University.

Table of Contents

"

Foreword to the Sixth Edition
Preface to the Sixth Edition
Abbreviations

1. Introduction

Health and Health Care
Health Care Systems
U.S. Health Care System
Future of the U.S. Health Care System
References

2. Health Care Workforce

Overview
Physicians
Nursing
Physicians Assistants
Health Care Workforce Outside the Hospital and Physician Office
Conclusion
References

3. Hospitals and Other Health Care Institutions

Introduction
SOME NUMBERS
Hospital Structure
Public General Hospitals
The Hospital in the Present Era
Long-Term Care: The Example of Nursing Homes
References

4. Primary and Ambulatory Care

Primary Care
Ambulatory Care
Conclusions
References

5. Government and the Health Care System

Introduction
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
Conclusions
References

6. Financing and Payment of Health Care

Introduction
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
Conclusions
References

7. Health Care System Performance

Introduction
Quality of Health Care
Equity of Health Care
Efficiency of Health Care
A National Scorecard
Data and Information Technology
Conclusion
References

8. From Prepaid Group Medical Practice to Managed Care

Introduction
Medical Group Practice
Health Maintenance Organizations
Managed Care
Integrated Delivery Systems
Managed Care Today
Some Policy Issues in Managed Care
References

9. Health Care Reform

Introduction
History of Change
National Health Insurance (NHI)
Some Contemporary Approaches to NHI
Looking Ahead
References
Epilogue
Appendix I List of Critical Reports
Appendix IISources of Data
Appendix IIIGlossary of Terms

"

Foreword

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.

Editorial Reviews

4 Stars! from Doody

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.

Judith Lee Kissell

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.

APHA Health Administration Newsletter