Despite the long and distinguished history of health services research in the United States, this unparalleled work is the first comprehensive account of what health services research aims to do and what the research has actually accomplished. Specially commissioned essays by a roster of leading scholars offer an incisive look at the current potential of the field.

This volume constitutes an achievement nowhere duplicated in the three related and critical areas of education, work, and manpower policy. It is the mature production of over a dozen years of research-endeavors by the dean of manpower studies.

In Part I Eli Ginzberg warns against simplistic reliance on prevailing models—economic, psychological, or political. There is only tenuous evidence that enormous expenditure leads to increased social benefit. Rather, we need a more appropriate framework for analyzing human resources, and we ought to be skeptical of a theory that predicates an underlying rationalism for much, if not all, human behavior. Specifically, the author doubts that education can be a substitute for the family, cure poverty or racism, assure an individual a job, give a person a decent income, or control crime and delinquency. What it can do is help students acquire basic skills and thereby help them to live and manage their lives better. The author suggests that we ought to set realistic goals for our schools and insist on accountability.

Part II turns to work and its discontents. Ginzberg examines the changing role of women, the position of blue-collar workers, labor reforms suggested in America and abroad, and the place of the work ethic.

Part III focuses mostly on public employment policy, which can improve the manpower system but can only be a minor instrument for promoting economic growth, redistributing income, shifting consumer demand to public services, or eliminating substandard jobs. The discussion will be eagerly read by those seeking to generate jobs for the unemployed.

Runaway medical costs, long-term care, market competition, for-profit medicine, nursing shortages—these are but a few of the issues that swirl around in the late twentieth century’s volatile health care scene. How much of the system do we want to change, and how much do we want to keep? Health policy expert Eli Ginzberg examines such crucial questions in his characteristically broad-gauged perspective. Framing the issues in their historical, political, and professional contexts, the author analyzes how we have arrived at the current crisis.

The book focuses on the three sides of the medical triangle that have separate and sometimes conflicting goals: the physicians want to provide the most health care for the most money; the government, which furnishes 40 percent of the system's funding, wants to limit the money it pays out for health care; and the public, with over a billion annual visits to doctors, wants the most health care for the least money.

Ginzberg explains how the core components of our health care system—the community hospital and physicians who have long practiced in a fee-for-service mode—are under attack, and he indicates the factors that make it uncertain whether the destabilization will slow down or accelerate. Moreover, can key health care centers maintain their leadership in a time when new dollars for health are scarce? How will the floundering state of foundations affect medical care in local communities?

In his final chapters the author zeroes in on the special concerns of the public: high-need patients (including those suffering from cancer, catastrophic illness, and the infirmities of old age, or those who are mentally ill or chronically poor), nursing shortages, unsuccessful cost containment, and lack of consensus within the medical triangle about the major issues on our nation's health agenda.