front cover of Big Med
Big Med
Megaproviders and the High Cost of Health Care in America
David Dranove and Lawton Robert Burns
University of Chicago Press, 2021
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet.

Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms.

In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised.
This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
[more]

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Big Med
Megaproviders and the High Cost of Health Care in America
David Dranove and Lawton Robert Burns
University of Chicago Press, 2021

This is an auto-narrated audiobook edition of this book.

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet.

Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms.

In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised.
This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

[more]

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The Cancer Within
Reproduction, Cultural Transformation, and Health Care in Romania
Cristina A. Pop
Rutgers University Press, 2022
The Cancer Within examines cervical cancer in Romania as a point of entry into an anthropological reflection on contemporary health care. Cervical cancer prevention reveals the inner workings of emerging post-communist medicine, which aligns the state and the market, public and private health care providers, policy makers, and ordinary women. Fashioned by patriarchal relations, lived religion, and the historical trauma of pronatalism, Romanian women’s responses to reproductive medicine and cervical cancer prevention are complicated by neoliberal reforms to medical care. Cervical cancer prevention – and especially the HPV vaccination – provided Romanians a legitimate instance to express their conflicting views of post-communist medicine. What sets Romania apart is that pronatalism, patriarchy, lived religion, medical reforms, and moral contestation of preventive medicine bring into line systemic contingencies that expose the historical, social, and cultural trajectories of cervical cancer.
 
[more]

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Catholic Witness in Health Care
Practicing Medicine in Truth and Love
John M. Travaline
Catholic University of America Press, 2017
Catholic health care is about ethics but also "ethos" – not only what we shouldn't do but a vision for what we should do with love. The issues it faces don't just concern academic bioethicists – they concern every faithful Catholic doctor, nurse, practitioner, and even patient. Modern medical practitioners on the ground, day-in, day-out, wrestling with medical moral matters, witnessing what is happening in American medicine today, while also striving to witness to their Catholic faith in living out their medical vocation – these are the primary authors of this unique book, and these are the readers it hopes to serve.

Catholic Witness in Health Care integrates the theoretical presentation of Catholic medical ethics with real life practice. It begins with fundamental elements of Catholic care, touching upon Scripture, moral philosophy, theology, Christian anthropology, and pastoral care. The second part features Catholic clinicians illuminating authentic Catholic medical care in their various medical disciplines: gynecology and reproductive medicine, fertility, pediatrics, geriatrics, critical care, surgery, rehabilitation, psychology, and pharmacy. Part three offers unique perspectives concerning medical education, research, and practice, with an eye toward creating a cultural shift to an authentically Catholic medical ethos.

Readers of this book will learn essential elements upon which the ethics of Catholic medical practice is founded and gain insights into practicing medicine and caring for others in an authentically Catholic way.
[more]

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COVID-19 and Public Health
Global Responses to the Pandemic
Caroline Kingori
Ohio University Press, 2024
This book contributes to the discourse on public health and COVID-19 prevention in three ways. First, by examining COVID-19’s impact on underserved and resource-limited communities, it addresses a continuing challenge in public health to ensure equitable access to adequate health care services. Contextually relevant initiatives must recognize and overcome injustices, stigma, racism, and discrimination in order to support the public health system. Second, the book argues that despite policies in high-income countries that led to the development and authorization of life-saving vaccines, attempts to curtail further transmission globally are futile without a concerted effort to ensure equal distribution of those vaccines. Third, it assesses the environmental impact of medical waste generated by COVID-19 as an emerging issue, one that cannot be glossed over with short-term solutions. Strategies to address medical waste like sanitizers, masks, gloves, and other products must be included in national policy to protect the populace and first responders. Utilizing a retrospective lens and examining lessons learned at the end of each chapter, COVID-19 and Public Health discusses global health success with other pandemics, risk communication, community engagement, interplay of policy and politics, environmental health influence, and public health practice implications. The book is suitable as an introductory text in public health or other related courses, such as environmental health, health policy, global health, health disparities, cross-cultural issues, community engagement, or health behavior. Contributors: Vashti Adams, Obasanjo Afolabi Bolarinwa, Adanna Agbo, Kobi V. Ajayi, Adaeze Aroh, Ugonwa Aroh, Timnit Berhane, Emma Biegacki, Claire Chaumont, Jaih Craddock, Marquitta Dorsey, Ghanem Elhersh, Kristen Garcia, Whitney Garney, Jessica Gokee LaRose, Jeffrey Glenn, F. Todd Gray, Rudene Haynes, Robert Heimer, Tamsim Hoque, Iman Ikram, Laeeq Khan, Kujang Laki, Rachel Ludeke, Devin Madden, Tyra Montour, Kenneth Morford, Michele Morrone, Maghboeba Mosavel, Carolyn Nganga-Good, Jerry Okal, Aggrey Willis Otieno, Sonya Panjwani, Elizabeth Prom-Wormley, Tremayne Robertson, Katie Schenk, Grace Sikapokoo, Vanessa Sheppard, Arnethea L. Sutton, Maria Thomson, Katherine Y. Tossas, Nita Vangeepuram, Pablo Villalobos Dintrans, Elizabeth Wachira, Robert A Winn, Rafeek Yusuf, Zenab Yusuf
[more]

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The Cultural Geography of Health Care
Wilbert M. Gesler
University of Pittsburgh Press, 1992

In health care delivery and health care research, basic concepts of cultural behavior are ignored—at a high personal and financial cost—because both fields are dominated by technical solutions and quantitative analysis. They have little use for what is often regarded as irrelevant information.
In this wide-ranging book, written for students and non-specialists, Gesler applies cultural geography to health care and shows that throughout the world, in western and developing countries alike, the social sciences can inform the medical sciences nd make them more effective and less expensive.

[more]

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Developing to Scale
Technology and the Making of Global Health
Heidi Morefield
University of Chicago Press, 2023
The first critical book on “appropriate technology,” Developing to Scale shows how global health came to be understood as a problem to be solved with the right technical interventions.
 
In 1973, economist E. F. Schumacher published Small Is Beautiful, which introduced a mainstream audience to his theory of “appropriate technology”: the belief that international development projects in the Global South were most sustainable when they were small-scale, decentralized, and balanced between the traditional and the modern. His theory gained widespread appeal, as cuts to the foreign aid budget, the national interests of nations seeking greater independence, postcolonial activism, and the rise of the United States’ tech sector drove stakeholders across public and private institutions toward cheaper tools. In the ensuing decades, US foreign assistance shifted away from massive modernization projects, such as water treatment facilities, toward point-of-use technologies like village water pumps and oral rehydration salts. This transition toward the small scale had massive implications for the practice of global health.
 
Developing to Scale tells the history of appropriate technology in international health and development, relating the people, organizations, and events that shaped this consequential idea. Heidi Morefield examines how certain technologies have been defined as more or less “appropriate” for the Global South based on assumptions about gender, race, culture, and environment. Her study shows appropriate technology to be malleable, as different constituencies interpreted its ideas according to their own needs. She reveals how policymakers wielded this tool to both constrain aid to a scale that did not threaten Western interests and to scale the practice of global health through the development and distribution of technical interventions.
[more]

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Doctors and the State
The Politics of Health Care in France and the United States
David Wilsford
Duke University Press, 1991
All advanced health care systems face severe difficulties in financing the delivery of today’s sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables—the autonomy of the state and the strength and cohesiveness of organized medicine—explain this variance.
In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult.
Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession’s clinical autonomy and physicians’ incomes.
[more]

front cover of Doctors and the State
Doctors and the State
The Politics of Health Care in France and the United States
David Wilsford
Duke University Press
All advanced health care systems face severe difficulties in financing the delivery of today’s sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables—the autonomy of the state and the strength and cohesiveness of organized medicine—explain this variance.
In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult.
Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession’s clinical autonomy and physicians’ incomes.
[more]

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Ethical Considerations in the Business Aspects of Health Care
Woodstock Theological Center
Georgetown University Press, 1995

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Ethics of Health Care
An Introductory Textbook, Third Edition
Benedict M. Ashley, OP, and Kevin D. O'Rourke, OP
Georgetown University Press, 2002

In the wake of the successful cloning of animals and the promises—or fears—of stem cell research, new discoveries in science and medicine need more than ever to be accompanied by careful moral reflection. Contending that concern over the ethical dimensions of these and other like issues are no longer just in the domain of those involved in medical practice, the third edition of Ethics of Health Care claims these are vital topics that should matter deeply to all citizens.

While stressing the Catholic tradition in health care ethics, Ethics of Health Care is ecumenical, incorporating a broader Christian tradition as well as humanistic approaches, and takes as common ground for mutual understanding the Universal Declaration of Human Rights of the United Nations. This new third edition is a response to the many developments in theology and the startlingly rapid changes in the arenas of medicine and health care over the past decade, from the dominance of managed care to increased surgery on an "outpatient" basis; from hospice care for the dying to the increasing use of drugs in the treatment of mental illness.

Revised and thoroughly up-to-date, this third edition continues with its valuable teaching aids, including case studies, study questions, chapter summaries, a bibliography, and complete index.

[more]

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Evidence
Its Meanings in Health Care and in Law, Volume 26
Mark Peterson, ed.
Duke University Press
Evidence: Its Meanings in Health Care and in Law examines the ways in which scientists, clinical practitioners, judges, legal scholars, and juries interpret and use evidence. The articles find that the concept and attributes of "evidence" depend on where one sits. They recognize the time-honored legal and medical science interpretation and operationalization of "evidence" while, at the same time, acknowledging that the health care system and the legal system would each benefit by sustained efforts of mutual education of practitioners in both fields. 
[more]

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From Monastery to Hospital
Christian Monasticism and the Transformation of Health Care in Late Antiquity
Andrew T. Crislip
University of Michigan Press, 2005

From Monastery to Hospital traces the origin of the late Roman hospital to the earliest groups of Christian monastics. Often characterized as holy men and miracle-workers who transformed late antique spirituality, monks held an equally significant impact on the development of medicine in Late Antiquity. Andrew Crislip illuminates the innovative approaches to health care within the earliest monasteries that provided the model for the greatest medical achievement of Late Antiquity: the hospital.

From Monastery to Hospital draws on some of the most vibrant areas of scholarship of the ancient world, including asceticism, the study of the body, history of the family, and the history of medicine. The book will be of interest to scholars and students of early Christianity, Roman History, the history of medicine, and Catholic, Coptic, and Eastern Orthodox history and theology. It will also be of interest to the broader field of history of Christianity, especially with its connections to charitable traditions in the church through the modern period.

Andrew Crislip is Assistant Professor of Religion at the University of Hawaii.

[more]

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Health Care and Gender
Charlotte Muller
Russell Sage Foundation, 1990
Health and medical services should meet individuals' needs regardless of gender, but in both subtle and overt ways this is very often not the case. Gender biases result not only in flawed access to care but also in insufficient medical research, uninformed diagnoses, and gaps in covering critical needs. In Health Care and Gender, Charlotte Muller provides a contemporary assessment of the forces that sustain gender biases in the health and medical professions. Beginning with an analysis of gender comparisons in health care usage and adequacy of treatment, Muller discusses the experiences of many different women: working women with insurance coverage, the poor dependent on Medicaid, and the elderly. She also focuses on the issues facing women of reproductive age and shows how poverty or extremely volatile political and ethical controversy may impede their search for basic maternity and family planning services. Drawing on a large body of evidence from medical, health, and behavioral literature and from national statistics, Health Care and Gender probes a timely and crucial topic. For scholars, analysts, and policy makers interested in women's studies, health and medical care, gerontology, consumer and labor economics, and social justice. Muller's thorough analysis looks to the future by presenting agendas for reform, research, and evaluation.
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Health Care as a Social Good
Religious Values and American Democracy
David M. Craig
Georgetown University Press, 2016

David M. Craig traveled across the United States to assess health care access, delivery and finance in this country. He interviewed religious hospital administrators and interfaith activists, learning how they balance the values of economic efficiency and community accountability. He met with conservatives, liberals, and moderates, reviewing their ideas for market reform or support for the Affordable Care Act. He discovered that health care in the US is not a private good or a public good. Decades of public policy and philanthropic service have made health care a shared social good.

Health Care as a Social Good: Religious Values and the American Democracy argues that as escalating health costs absorb more and more of family income and government budgets, we need to take stock of the full range of health care values to create a different and more affordable community-based health care system. Transformation of that system is a national priority but Americans have failed to find a way to work together that bypasses our differences. Craig insists that community engagement around the common religious conviction that healing is a shared responsibility can help us achieve this transformation—one that will not only help us realize a new and better system, but one that reflects the ideals of American democracy and the common good.

[more]

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Health Extension
Community-Based Healthcare and the Future of Cooperative Extension
Cheryl L. Eschbach
Michigan State University Press, 2024

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Helping and Healing
Religious Commitment in Health Care
Edmund D. Pellegrino and David C. Thomasma
Georgetown University Press, 1997

Exploring the moral foundations of the healing relationship, Edmund D. Pellegrino and David C. Thomasma offer the health care professional a highly readable Christian philosophy of medicine. This book examines the influence religious beliefs have on the kind of person the health professional should be, on the health care policies a society should adopt, and on what constitutes healing in its fullest sense.

Helping and Healing looks at the ways a religious perspective shapes the healing relationship and the ethics of that relationship. Pellegrino and Thomasma seek to clarify the role of religious belief in health care by providing a moral basis for such commitment as well as a balancing role for reason. This book establishes a common ground for believers and skeptics alike in their dedication to relieve suffering by showing that helping and healing require an involvement in the religious values of patients. It clearly argues that religion provides crucial insights into medical practice and morality that cannot be ignored, even in our morally heterogeneous society.

Central to the authors' message is the concept of patients' vulnerabilities and the need to help them recover not only from the disease but also from an existential assault on their personhood. They then show how this understanding can move caregivers to view their professions as vocations and thereby change the nature of health care from a business to a community of healing.

Physicians, nurses, administrators, clergy, theologians, and other health professionals and church leaders will find this volume helpful for their own reflections on the role of religion in the health care ministry and for making a religious commitment integral to their professional lives.

[more]

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How to Respond Better to the Next Pandemic
Remedying Institutional Failures
Allen Buchanan, with contributions by Cécile Fabre and Sir Paul Tucker
University of Utah Press, 2024
There is no shortage of criticisms of U.S. COVID-19 policy. This book argues that officials at the highest levels lied to the public or deliberately suppressed relevant information, shamelessly over-sold the efficacy of masks and vaccines, and enacted lock-down policies of unproven value that caused massive economic, educational, and psycho-social damage.

In How to Respond Better to the Next Pandemic Allen Buchanan argues that, contrary to widespread opinion, the primary cause of flawed COVID-19 policy was not defective leadership, but rather institutional failure. Decisions were made through processes that lacked the most basic safeguards against the large-institution “yes-man” and group-think phenomena and included virtually no provisions for holding decision makers accountable. More fundamentally, policy makers did not fulfill the crucial duty to provide plausible public justifications for their decisions. They disguised the fact that scientific opinion was divided on the appropriateness of the policies they endorsed and labeled those who disagreed with them as anti-scientific. In some cases, they responded to criticism, not by engaging it on the issues, but by branding their critics as quacks.
[more]

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Indigenous Health and Justice
Edited by Karen Jarratt-Snider and Marianne O. Nielsen
University of Arizona Press, 2024
Colonial oppression, systemic racism, discrimination, and poor access to a wide range of resources detract from Indigenous health and contribute to continuing health inequities and injustices. These factors have led to structural inadequacies that contribute to circular challenges such as chronic underfunding, understaffing, and culturally insensitive health-care provision. Nevertheless, Indigenous Peoples are working actively to end such legacies.

In Indigenous Health and Justice contributors demonstrate how Indigenous Peoples, individuals, and communities create their own solutions. Chapters focus on both the challenges created by the legacy of settler colonialism and the solutions, strengths, and resilience of Indigenous Peoples and communities in responding to these challenges. It introduces a range of examples, such as the ways in which communities use traditional knowledge and foodways to address health disparities.

Indigenous Health and Justice is the fifth volume in the Indigenous Justice series. The series editors have focused on different aspects of the many kinds of justice that affect Indigenous Peoples. This volume is for students, scholars, activists, policymakers, and health-care professionals interested in health and well-being.
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Junctures in Women's Leadership
Health Care and Public Health
Mary E. O'Dowd
Rutgers University Press, 2021
Junctures in Women’s Leadership: Health Care and Public Health offers an eclectic compilation of case studies telling the stories of women leaders in public health and health care, from Katsi Cook, Mohawk midwife, to Virginia Apgar, Katharine Dexter McCormick and Florence Schorske Wald, to Marilyn Tavenner, Suerie Moon, and more. The impact of their work is extraordinarily relevant to the current public discourse including subjects such as the global COVID-19 pandemic, disparities in health outcomes, prevention of disease and the impact of the Affordable Care Act. The leadership lessons gleaned from these chapters can be applied to a broad array of disciplines within government, private business, media, philanthropy, pharmaceutical, environmental and health sectors. Each chapter is authored by a well versed and accomplished woman, demonstrating the book’s theme that there are many paths within health care and public health. The case study format provides an introductory section providing biographical and historical background, setting the stage for a juncture, or decision point, and the resolution. The women are compelling characters and worth knowing.
[more]

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Just Don't Get Sick
Access to Health Care in the Aftermath of Welfare Reform
Seccombe, Karen
Rutgers University Press, 2007
The ability to obtain health care is fundamental to the security, stability, and well-being of poor families. Government-sponsored programs provide temporary support, but as families leave welfare for work, they find themselves without access to coverage or care. The low-wage jobs that individuals in transition are typically able to secure provide few benefits yet often disqualify employees from receiving federal aid.

Drawing upon statistical data and in-depth interviews with over five hundred families in Oregon, Karen Seccombe and Kim Hoffman assess the ways in which welfare reform affects the well-being of adults and children who leave the program for work. We hear of asthmatic children whose uninsured but working mothers cannot obtain the preventive medicines to keep them well, and stories of pregnant women receiving little or no prenatal care who end up in emergency rooms with life-threatening conditions.

Representative of poor communities nationwide, the vivid stories recounted here illuminate the critical relationship between health insurance coverage and the ability to transition from welfare to work.
[more]

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Kenneth Arrow and the Changing Economics of Health Care, Volume 26
Mark A. Peterson, ed.
Duke University Press
This special issue of the Journal of Health Politics, Policy and Law centers on Nobel laureate Kenneth J. Arrow’s seminal article "Uncertainty and the Welfare Economics of Medical Care." When the essay first appeared in 1963, health economics did not exist as an established field, and there was a professional and social bias against thinking about health care in economic terms. Arrow’s trailblazing article laid the foundation for modern health economics and has guided its direction for four decades.

Now the Journal of Health Politics, Policy and Law examines this legacy, opening with a foreword by Mark V. Pauly, one of the first to publish a response to Arrow’s original article and a major voice in health economics today. A reprint of the article itself serves as a springboard from which contributors assess the accuracy of Arrow’s portrayal of the United States health care system in the early sixties and evaluate how the system has progressed since that time. The contributors to this remarkable collection include some of the most distinguished scholars in the health policy field.

Designed to be an effective reference tool, this issue sets Arrow’s original article apart from the rest by printing it on tinted paper. The contributors’ responses to Arrow are divided into four parts—Part 1: Supply, Demand, and Health Care Competition; Part 2: Risk, Insurance, and Redistribution; Part 3: Information, Knowledge, and Medical Markets; Part 4: Social Norms and Professionalism.

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Mama Might Be Better Off Dead
The Failure of Health Care in Urban America
Laurie Kaye Abraham
University of Chicago Press, 1994
North Lawndale, a neighborhood that lies in the shadows of Chicago’s Loop, is surrounded by some of the city’s finest medical facilities, Yet, it is one of the sickest, most medically underserved communities in the country.

Mama Might Be Better Off Dead immerses readers in the lives of four generations of a poor, African-American family in the neighborhood, who are beset with the devastating illnesses that are all too common in America’s inner-cities. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Laurie Kaye Abraham chronicles their access—or more often, lack thereof—to medical care. Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty.

Both disturbing and illuminating, Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care in America. Published to great acclaim in 1993, the book in this new edition includes an incisive foreword by David Ansell, a physician who worked at Mt. Sinai Hospital, where much of the Banes family’s narrative unfolds.

 
[more]

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Mama Might Be Better Off Dead
The Failure of Health Care in Urban America
Laurie Kaye Abraham
University of Chicago Press, 1993
Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care. Both disturbing and illuminating, it immerses readers in the lives of four generations of a poor, African-American family beset with the devastating illnesses that are all too common in America's inner-cities.

The story takes place in North Lawndale, a neighborhood that lies in the shadows of Chicago's Loop. Although surrounded by some of the city's finest medical facilities, North Lawndale is one of the sickest, most medically underserved communities in the country. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Abraham chronicles their access (or lack of access) to medical care.

Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty. When people are poor, they become sick easily. When people are sick, their families quickly become poorer.

Embedded in the family narrative is a lucid analysis of the gaps, inconsistencies, and inequalities the poor face when they seek health care. This book reveals what health care policies crafted in Washington, D. C. or state capitals look like when they hit the street. It shows how Medicaid and Medicare work and don't work, the Catch-22s of hospital financing in the inner city, the racial politics of organ transplants, the failure of childhood immunization programs, the vexed issues of individual responsibility and institutional paternalism. One observer puts it this way: "Show me the poor woman who finds a way to get everything she's entitled to in the system, and I'll show you a woman who could run General Motors."

Abraham deftly weaves these themes together to make a persuasive case for health care reform while unflinchingly presenting the complexities that will make true reform as difficult as it is necessary. Mama Might Be Better Off Dead is a book with the power to change the way health care is understood in America. For those seeking to learn what our current system of health care promises and what it delivers, it offers a place for the debate to begin.


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Medicine, Health Care, & Ethics
Catholic Voices
John F. Morris
Catholic University of America Press, 2007
Medicine, Health Care, and Ethics adds to this rich tradition with a collection of contemporary essays that represent the very best efforts of current Catholic scholarship in the field of health care and medical ethics.
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Navigating the Cultures of Health Care and Health Insurance
Highly Skilled Migrants in the U.S.
Nina Zeldes
University College London, 2023
A qualitative and quantitative approach to the study of foreign patients’ utilization and assessment of health care in the United States.

What are the barriers preventing migrants from accessing and successfully using health care in their new home country? Do these barriers vary based on the migrants’ country of origin? And are they a problem for highly skilled migrants, who often have well-paid jobs and health insurance provided by their employers? Based on field research conducted in the Washington DC area, Navigating the Cultures of Health Care and Health Insurance brings together mixed methods, qualitative, and quantitative approaches to the study of foreign patients’ utilization and assessment of health care in the United States. Through interviews with both health care providers and patients, attitudes toward health insurance and medical treatment are compared for migrants from three countries with very different cultural backgrounds and health insurance systems: Germany, India, and Japan. 
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No Longer Patient
Feminist Ethics and Health Care
Susan Sherwin
Temple University Press, 1992

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Organizing Locally
How the New Decentralists Improve Education, Health Care, and Trade
Bruce Fuller
University of Chicago Press, 2015
We love the local. From the cherries we buy, to the grocer who sells them, to the school where our child unpacks them for lunch, we express resurgent faith in decentralizing the institutions and businesses that arrange our daily lives. But the fact is that huge, bureaucratic organizations often still shape the character of our jobs, schools, the groceries where we shop, and even the hospitals we entrust with our lives. So how, exactly, can we work small, when everything around us is so big, so global and standardized? In Organizing Locally, Bruce Fuller shows us, taking stock of America’s rekindled commitment to localism across an illuminating range of sectors, unearthing the crucial values and practices of decentralized firms that work.
           
Fuller first untangles the economic and cultural currents that have eroded the efficacy of—and our trust in—large institutions over the past half century. From there we meet intrepid leaders who have been doing things differently. Traveling from a charter school in San Francisco to a veterans service network in Iowa, from a Pennsylvania health-care firm to the Manhattan branch of a Swedish bank, he explores how creative managers have turned local staff loose to craft inventive practices, untethered from central rules and plain-vanilla routines. By holding their successes and failures up to the same analytical light, he vividly reveals the key cornerstones of social organization on which motivating and effective decentralization depends. Ultimately, he brings order and evidence to the often strident debates about who has the power—and on what scale—to structure how we work and live locally.

Written for managers, policy makers, and reform activists, Organizing Locally details the profound decentering of work and life inside firms, unfolding across postindustrial societies. Its fresh theoretical framework explains resurging faith in decentralized organizations and the ingredients that deliver vibrant meaning and efficacy for residents inside. Ultimately, it is a synthesizing study, a courageous and radical new way of conceiving of American vitality, creativity, and ambition. 
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Pandemic Solidarity
Mutual Aid during the Coronavirus Crisis
Marina Sitrin
Pluto Press, 2020

“Helps us to rethink and re-imagine an egalitarian society where no one is left behind”—London School of Economics Review of Books

In times of crisis, when institutions of power are laid bare, people turn to one another. Pandemic Solidarity collects firsthand experiences from around the world of people creating their own narratives of solidarity and mutual aid in the time of the global crisis of COVID-19.

The world's media was quick to weave a narrative of selfish individualism, full of empty supermarket shelves and con-men. However, if you scratch the surface, you find a different story of community and self-sacrifice.
 
Looking at thirteen countries and regions, including India, Rojava, China and the US, the personal accounts in the book weave together to create a larger picture, revealing a universality of experience - a housewife in Istanbul supports her neighbor in the same way as a punk in Portland, and a grandmother in Italy does. Moving beyond the present, these stories reveal what an alternative society could look like, and reflect the skills and relationships we already have to create that society, challenging institutions of power that have already shown their fragility. Chapters include:
 
*Capitalism Kills, Solidarity Gives Life": A Glimpse of Solidarity Networks from Turkey
*Solidarity Network in Iraq During Covid-19: This Time the Enemy is Invisible
*Sharing Spaces and Crossing Borders: Voices from Taiwan
*Rethinking Minority and Mainstream in India
*Confronting State Authoritarianism: Civil Society and Community-Based Solidarity in Southern Africa
*On Intersectional Solidarity in Portugal
*Solidarity Networks in Greece
*Argentina: Injustices Magnified; Memories of Resistance Reactivated
*On Grassroots Organizing: Excerpts from Brazil

What happens to society when we are not held back by the neoliberal narrative? What can we do, to protect ourselves and one another, when we organize and act collectively? From the stories told here, maybe more than we expect.                   

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The Political Geographies of Pregnancy
Laura R. Woliver
University of Illinois Press, 2002

A searing study of how modern reproductive politics shapes women's bodily agency

Pregnancy indisputably takes place within a woman's body. But as reproductive power finds its way into the hands of medical professionals, lobbyists, and policymakers, the geographies of pregnancy are shifting, and the boundaries need to be redrawn, argues Laura R. Woliver. The Political Geographies of Pregnancy is a vigorous analysis of the ways modern reproductive politics are shaped by long-standing debates on abortion and adoption, surrogacy arrangements, new reproductive technologies, medical surveillance, and the mapping of the human genome.

Across a politically charged backdrop of reproductive issues, Woliver exposes strategies that claim to uphold the best interests of children, families, and women but in reality complicate women's struggles to have control over their own bodies. Utilizing feminist standpoint theory and promoting a feminist ethic of care, Woliver looks at abortion politics, modern adoption laws that cater to male-headed families, regulations that allow the state to monitor pregnant women but not always provide care for them, and the power structures behind the seemingly benign world of egg-selling and surrogate parenting. She also considers the potentially staggering political implications of mapping the human genome, and the exclusion of women's perspectives in discussions about legislation and advancements in reproductive technologies.

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Principles of Green Bioethics
Sustainability in Health Care
Cristina Richie
Michigan State University Press, 2019
Health care is ubiquitous in the industrialized world. Yet, every medical development, technique, and procedure impacts the environment. Green bioethics synthesizes environmental ethics and biomedical ethics, thus creating an interdisciplinary approach to sustainable health care. Notably, green bioethics addresses not the structure of environmental sustainability in health-care institutions but the sustainability of individual health-care offerings. It parallels traditional biomedical ethics by providing four principles for ethical guidance: distributive justice, resource conservation, simplicity, and ethical economics. Through these four principles, green bioethics presents a coherent framework for evaluating the sustainability of medical developments, techniques, and procedures. The future of our world may very well depend on how effectively we halt ecological destruction and conserve our resources in all areas of life. The principles of green bioethics, outlined in this book, will advance sustainability in health care.
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The Rebirth of the Clinic
An Introduction to Spirituality in Health Care
Daniel P. Sulmasy, OFM, MD
Georgetown University Press, 2006

The Rebirth of the Clinic begins with a bold assertion: the doctor-patient relationship is sick. Fortunately, as this engrossing book demonstrates, the damage is not irreparable. Today, patients voice their desires to be seen not just as bodies, but as whole people. Though not willing to give up scientific progress and all it has to offer, they sense the need for more. Patients want a form of medicine that can heal them in body and soul. This movement is reflected in medical school curricula, in which courses in spirituality and health care are taught alongside anatomy and physiology. But how can health care workers translate these concepts into practice? How can they strike an appropriate balance, integrating and affirming spirituality without abandoning centuries of science or unwittingly adopting pseudoscience?

Physician and philosopher Daniel Sulmasy is uniquely qualified to guide readers through this terrain. At the outset of this accessible, engaging volume, he explores the nature of illness and healing, focusing on health care's rich history as a spiritual practice and on the human dignity of the patient. Combining sound theological reflection with doses of healthy skepticism, he goes on to describe empirical research on the effects of spirituality on health, including scientific studies of the healing power of prayer, emphasizing that there are reasons beyond even promising research data to attend to the souls of patients. Finally, Sulmasy devotes special attention and compassion to the care of people at the end of life, incorporating the stories of several of his patients.

Throughout, the author never strays from the theme that, for physicians, attending to the spiritual needs of patients should not be a moral option, but a moral obligation. This book is an essential resource for scholars and students of medicine and medical ethics and especially medical students and health care professionals.

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Seeing Patients
Unconscious Bias in Health Care
Augustus A. White III M.D.
Harvard University Press, 2011

If you’re going to have a heart attack, an organ transplant, or a joint replacement, here’s the key to getting the very best medical care: be a white, straight, middle-class male. This book by a pioneering black surgeon takes on one of the few critically important topics that haven’t figured in the heated debate over health care reform—the largely hidden yet massive injustice of bias in medical treatment.

Growing up in Jim Crow–era Tennessee and training and teaching in overwhelmingly white medical institutions, Gus White witnessed firsthand how prejudice works in the world of medicine. And while race relations have changed dramatically, old ways of thinking die hard. In Seeing Patients White draws upon his experience in startlingly different worlds to make sense of the unconscious bias that riddles medical treatment, and to explore what it means for health care in a diverse twenty-first-century America.

White and coauthor David Chanoff use extensive research and interviews with leading physicians to show how subconscious stereotyping influences doctor–patient interactions, diagnosis, and treatment. Their book brings together insights from the worlds of social psychology, neuroscience, and clinical practice to define the issues clearly and, most importantly, to outline a concrete approach to fixing this fundamental inequity in the delivery of health care.

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Stable Condition
Elites' Limited Influence on Health Care Attitudes
Daniel J. Hopkins
Russell Sage Foundation, 2023
The Affordable Care Act (ACA), the sweeping health care reform enacted by the Obama Administration in 2010, continues to be a contentious policy at the center of highly polarized political debates. Both before and after the law’s passage, political elites on both sides of the issue attempted to sway public opinion through two traditional approaches: messaging and policymaking itself.  They operated under the assumption that the public’s personal experiences toward the law would make them more favorable. Yet these tried-and-true methods have had limited influence on public attitudes toward the ACA. Public opinion towards the ACA remained stable from 2010 to 2016, with more Americans opposing the law than supporting it. It was only after Donald Trump was elected in 2016 and the prospect of the law being repealed became a reality that public opinion swung in favor of the ACA. If traditional methods of influencing public opinion had little impact on attitudes towards the ACA, what did? In Stable Condition, political scientist Daniel J. Hopkins draws on survey data from 2009 to 2020 to assess how a variety of factors such as personal experience, political messaging, and partisanship did or did not affect public opinion on the ACA.
 
Hopkins finds that although personal experience with the ACA’s Medicaid expansion increased favorability among low-income Americans, it did not have a broader overall impact on public opinion. Personal experience with the Health Insurance Marketplace did not increase wider support for the ACA either. Due to the complex nature of the law, users of the Marketplace often did not realize they were benefiting from the ACA. Therefore, perceptions of the Marketplace were shaped by high-profile issues with the enrollment website and opposition to the individual mandate. These experiences ultimately offset one another, resulting in little discernable change in public opinion overall. Hopkins argues that political polarization was also responsible for elite’s limited influence and that public opinion on the ACA was largely determined by partisanship and political affiliation. Americans quickly aligned with their party’s stance on the law and were resistant to changing their beliefs despite the efforts of political elites. 
 
Stable Condition is an illuminating examination of the limits of elites’ influence and the forces that shaped public opinion about the Affordable Care Act.
 
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Technological Change in Health Care
A Global Analysis of Heart Attack
Mark B. McClellan and Daniel P. Kessler, Editors
University of Michigan Press, 2002
Evidence from the United States suggests that technological change is a key factor in understanding both medical expenditure growth and recent dramatic improvements in the health of people with serious illnesses. Yet little international research has examined how the causes and consequences of technological change in health care differ worldwide. Seeking to illuminate these issues, this volume documents how use of high-technology treatments for heart attack changed in fifteen developed countries over the 1980s and 1990s. Drawn from the collaborative effort of seventeen research teams in fifteen countries, it provides a cross-country analysis of microdata that illuminates the relationships between public policies toward health care, technology, costs, and health outcomes.
The comparisons presented here confirm that the use of medical technology in treatment for heart attack is strongly related to incentives, and that technological change is an important cause of medical expenditure growth in all developed countries. Each participating research team reviewed the economic and regulatory incentives provided by their country's health system, and major changes in those incentives over the 1980s and 1990s, according to a commonly used framework. Such incentives include: the magnitude of out-of-pocket costs to patients, the generosity of reimbursement to physicians and hospitals, regulation of the use of new technologies or the supply of physicians, regulation of competition, and the structure of hospital ownership. Each team also reviewed how care for heart attacks has changed in their country over the past decade.
The book will be of enormous importance to health economists, medical researchers and epidemiologists, and policymakers.
Mark McClellan is Associate Professor of Economics and of Medicine and, by courtesy, of Health Research and Policy, Stanford University. He is a National Fellow, the Hoover Institution. Daniel P. Kessler is Associate Professor of Economics, Law, and Policy in the Graduate School of Business, Stanford University, and a Research Fellow, the Hoover Institution.
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Uncertain Times
Kenneth Arrow and the Changing Economics of Health Care
Peter J. Hammer, Deborah Haas-Wilson, Mark A. Peterson, and William M. Sage, eds.
Duke University Press, 2003
This volume revisits the Nobel Prize-winning economist Kenneth Arrow’s classic 1963 essay “Uncertainty and the Welfare Economics of Medical Care” in light of the many changes in American health care since its publication. Arrow’s groundbreaking piece, reprinted in full here, argued that while medicine was subject to the same models of competition and profit maximization as other industries, concepts of trust and morals also played key roles in understanding medicine as an economic institution and in balancing the asymmetrical relationship between medical providers and their patients. His conclusions about the medical profession’s failures to “insure against uncertainties” helped initiate the reevaluation of insurance as a public and private good.

Coming from diverse backgrounds—economics, law, political science, and the health care industry itself—the contributors use Arrow’s article to address a range of present-day health-policy questions. They examine everything from health insurance and technological innovation to the roles of charity, nonprofit institutions, and self-regulation in addressing medical needs. The collection concludes with a new essay by Arrow, in which he reflects on the health care markets of the new millennium. At a time when medical costs continue to rise, the ranks of the uninsured grow, and uncertainty reigns even among those with health insurance, this volume looks back at a seminal work of scholarship to provide critical guidance for the years ahead.

Contributors
Linda H. Aiken
Kenneth J. Arrow
Gloria J. Bazzoli
M. Gregg Bloche
Lawrence Casalino
Michael Chernew
Richard A. Cooper
Victor R. Fuchs
Annetine C. Gelijns
Sherry A. Glied
Deborah Haas-Wilson
Mark A. Hall
Peter J. Hammer
Clark C. Havighurst
Peter D. Jacobson
Richard Kronick
Michael L. Millenson
Jack Needleman
Richard R. Nelson
Mark V. Pauly
Mark A. Peterson
Uwe E. Reinhardt
James C. Robinson
William M. Sage
J. B. Silvers
Frank A. Sloan
Joshua Graff Zivin

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Within Reason
A Liberal Public Health for an Illiberal Time
Sandro Galea
University of Chicago Press, 2023

A provocative chronicle of how US public health has strayed from its liberal roots.

The Covid-19 response was a crucible of politics and public health—a volatile combination that produced predictably bad results. As scientific expertise became entangled with political motivations, the public-health establishment found itself mired in political encampment.

It was, as Sandro Galea argues, a crisis of liberalism: a retreat from the principles of free speech, open debate, and the pursuit of knowledge through reasoned inquiry that should inform the work of public health.

Across fifty essays, Within Reason chronicles how public health became enmeshed in the insidious social trends that accelerated under Covid-19. Galea challenges this intellectual drift towards intolerance and absolutism while showing how similar regressions from reason undermined social progress during earlier eras. Within Reason builds an incisive case for a return to critical, open inquiry as a guiding principle for the future public health we want—and a future we must work to protect.

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