Some central questions in the natural and social sciences can't be answered by controlled laboratory experiments, often considered to be the hallmark of the scientific method. This impossibility holds for any science concerned with the past. In addition, many manipulative experiments, while possible, would be considered immoral or illegal. One has to devise other methods of observing, describing, and explaining the world.
In the historical disciplines, a fruitful approach has been to use natural experiments or the comparative method. This book consists of eight comparative studies drawn from history, archeology, economics, economic history, geography, and political science. The studies cover a spectrum of approaches, ranging from a non-quantitative narrative style in the early chapters to quantitative statistical analyses in the later chapters. The studies range from a simple two-way comparison of Haiti and the Dominican Republic, which share the island of Hispaniola, to comparisons of 81 Pacific islands and 233 areas of India. The societies discussed are contemporary ones, literate societies of recent centuries, and non-literate past societies. Geographically, they include the United States, Mexico, Brazil, western Europe, tropical Africa, India, Siberia, Australia, New Zealand, and other Pacific islands.
In an Afterword, the editors discuss how to cope with methodological problems common to these and other natural experiments of history.
Health care delivery in the United States is an enormously complex enterprise, and its $1.6 trillion annual expenditures involve a host of competing interests. While arguably the nation offers among the most technologically advanced medical care in the world, the American system consistently under performs relative to its resources. Gaps in financing and service delivery pose major barriers to improving health, reducing disparities, achieving universal insurance coverage, enhancing quality, controlling costs, and meeting the needs of patients and families.
Bringing together twenty-five of the nation’s leading experts in health care policy and public health, this book provides a much-needed perspective on how our health care system evolved, why we face the challenges that we do, and why reform is so difficult to achieve. The essays tackle tough issues including: socioeconomic disadvantage, tobacco, obesity, gun violence, insurance gaps, the rationing of services, the power of special interests, medical errors, and the nursing shortage.
Linking the nation’s health problems to larger political, cultural, and philosophical contexts, Policy Challenges in Modern Health Care offers a compelling look at where we stand and where we need to be headed.
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