The American Medical Association asked RAND Health to characterize the factors that affect physician professional satisfaction. RAND researchers sought to identify high-priority determinants of professional satisfaction by gathering data from 30 physician practices in six states, using a combination of surveys and semistructured interviews. This report presents the results of the subsequent analysis.

More than six million Americans—most of them women—have been diagnosed with fibromyalgia syndrome (FMS), a disorder that produces musculo-skeletal pain and fatigue. In the absence of visible evidence, a well-understood cause, or effective treatment, many have questioned whether FMS is a "real" illness. Amidst the controversy, millions of women live with their very real symptoms.Rather than taking sides in the heated debate, Kristin Barker explains how FMS represents an awkward union between the practices of modern medicine and the complexity of women's pain. Using interviews with sufferers, Barker focuses on how the idea of FMS gives meaning and order to women beset by troubling symptoms, self-doubt, and public skepticism.This book offers a fresh look at a controversial diagnosis; Barker avoids overly simplistic explanations and empathizes with sufferers without losing sight of the social construction of disease and its relation to modern medical practice.

The Affordable Care Act places strong emphasis on quality of care as a means to improve outcomes for Americans and promote the financial sustainability of our health care system. This report attempts to help employers understand the structural differences between health plans and the performance dimensions along which plans can differ, as well as to educate employers about available tools that can be used to evaluate plan options.

Among the most serious challenges facing health systems in lower and middle income countries is establishing efficient, fair, and sustainable financing mechanisms that offer universal protection. Lack of financial protection forces families to suffer the burden not only of illness but also of economic ruin and impoverishment. In Latin America, financial protection for health continues to be segmented and fragmented; health is mainly financed through out-of-pocket payments.

Financing Health in Latin America presents new and important insight into the crucial issue of financial protection in health systems. The book analyzes the level and determinants of catastrophic health expenditures among households in Argentina, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Mexico, and Peru, applying both descriptive and econometric analyses. The results demonstrate that out-of-pocket health spending is pushing large segments of the population into impoverishment and that the poorest and most vulnerable segments of the population are most at risk of financial catastrophe. This work is a product of the collaboration between more than 25 researchers and 18 institutions associated with the Research for Health Financing in Latin America and the Caribbean Network, with support from the International Development Research Centre of Canada.

Conventional wisdom holds that programs for the poor are vulnerable to instability and retrenchment. Medicaid, however, has grown into the nation’s largest intergovernmental grant program, accounting for nearly half of all federal funding to state and local governments. Medicaid’s generous open-ended federal matching grants have given governors a powerful incentive to mobilize on behalf of its maintenance and expansion, using methods ranging from lobbying and negotiation to creative financing mechanisms and waivers to maximize federal financial assistance. Perceiving federal retrenchment efforts as a threat to states’ finances, governors, through the powerful National Governors’ Association, have repeatedly worked together in bipartisan fashion to defend the program against cutbacks.

Financing Medicaidengagingly intertwines theory, historical narrative, and case studies, drawing on sources including archival materials from the National Governors’ Association and gubernatorial and presidential libraries, Centers for Medicare and Medicaid Services data, the Congressional Record, and interviews.

Medical care prices in the United States are not only the most expensive in the world, but there are wide variations in what physicians are paid. Doctors at the frontlines of medical care who manage complex conditions argue that they receive disproportionately lower fees than physicians performing services such as minor surgeries and endoscopies. Fixing Medical Prices goes to the heart of the U.S. medical pricing process: to a largely unknown yet influential committee of medical organizations affiliated with the American Medical Association that advises Medicare. Medicare’s ready acceptance of this committee’s recommendations typically sets off a chain reaction across the entire American health care system.

For decades, the U.S. policymaking structure for pricing has reflected the influence of physician organizations. What Miriam Laugesen’s rich analysis shows is how these organizations navigate the arcane and complex work of this advisory committee. Contradicting the story of a profession in political decline, Fixing Medical Prices demonstrates that the power of physician organizations has simply become more subtle.

Laugesen’s investigation into the exorbitant cost of American medical care will be of interest to those who follow the politics of health care policy, the influence of interest groups on rate setting, and the medical profession’s past and future role in our health care system.

The National Defense Authorization Act for fiscal year 2020 directed the Secretary of Defense to report on food insecurity among members of the armed forces and their dependents. RAND researchers examined the eight elements from the directive (including an assessment of the current extent of food insecurity among service members and their dependents) and developed answers, along with listing areas requiring additional analysis.

From 1971 to 1982, researchers at the RAND Corporation devised an experiment to address two key questions in health care financing: how much more medical care will people use if it is provided free of charge? and what are the consequences for their health? This book presents a comprehensive account of the experiment and its findings. It will be an invaluable teaching tool and reference for anyone concerned with health-care policy.

Americans are understandably concerned about the runaway costs of medical care and the fact that one citizen out of seven is without health insurance coverage. Solving these problems is a top priority for the Clinton administration, but as Victor Fuchs shows, the task is enormously complex. In this book Fuchs, America's foremost health economist, provides the reader with the necessary concepts, facts, and analyses to comprehend the complicated issues of health policy. He shows why health care reform that benefits society as a whole will unavoidably burden certain individuals and groups.

Fuchs addresses such central questions as cost containment, managed competition, technology assessment, poverty and health, children's health, and national health insurance. The future of U.S. health policy, he argues, is tightly linked to three basic questions; First, how can we disengage health insurance from employment? Second, how can we tame technological change in health care? And finally how can we cope with the runaway medical costs of an aging society?