Medicine's changing economics have already fundamentally, permanently altered the relationship between physician and patient, E. Haavi Morreim argues. Physicians must weigh a patient's interests against the legitimate, competing claims of other patients, of payers, of society as a whole, and sometimes even of the physician himself.
Focusing on actual situations in the clinical setting, Morreim explores the complex moral problems that current economic realities pose for the practicing physician. She redefines the moral obligations of both physicians and patients, traces the specific effects of these redefined obligations on clinical practice, and explores the implications for patients as individuals and for national health policy. Although the book focuses on health care in the United States, physicians everywhere are likely to face many of the same basic issues of clinical ethics, because every system of health care financing and distribution today is constrained by finite resources.
"John Tishman is a true pioneer in the Construction Management industry. Through his CM leadership, some of America's most well-known buildings have been brought to successful completion."
---Bruce D'Agostino, president and chief executive, Construction Management Association of America
"Building Tall will provide readers with insights into John Tishman's career as a visionary engineer, landmark builder, and great businessman. Responsible for some of the construction world's most magnificent projects, John is one of the preeminent alumni in the history of Michigan Engineering. His perspectives have helped me throughout my time as dean, and his impact will influence generations of Construction Management professionals and students."
---David C. Munson, Jr., Robert J. Vlasic Dean of Engineering, University of Michigan
In this memoir, University of Michigan graduate John L. Tishman recounts the experiences and rationale that led him to create the entirely new profession now recognized and practiced as Construction Management. It evolved from his work as the construction lead of the "owner/builder" firm Tishman Realty and Construction, and his personal role as hands-on Construction Manager in the building of an astonishing array of what were at the time the world's tallest and most complex projects. These include
Tishman interweaves the stories behind the construction of these and many other important buildings and projects with personal reminiscences of his dealings with Henry Ford, Jr., Disney's Michael Eisner, casino magnate Steve Wynn, and many others into a practical history of the field of Construction Management, which he pioneered.
This book will be of interest not only to a general public interested in the stories and personalities behind many of the most iconic construction projects of the post–World War II period in the United States but to students of engineering and architecture and members of the new field of Construction Management.
Criminal justice expenditures have more than doubled since the 1980s, dramatically increasing costs to the public. With state and local revenue shortfalls resulting from the recent recession, the question of whether crime control can be accomplished either with fewer resources or by investing those resources in areas other than the criminal justice system is all the more relevant.
In this concise, straightforward analysis, Jost challenges the historical and theoretical assumptions on which the consumer-driven health care movement is based and reexamines the empirical evidence that it claims as support. He traces the histories of both private health insurance in the United States and the CDHC movement. The idea animating the drive for consumer-driven health care is that the fundamental problem with the American health care system is what economists call “moral hazard,” the risk that consumers overuse services for which they do not bear the cost. Jost reveals moral hazard as an inadequate explanation of the complex problems plaguing the American health care system, and he points to troubling legal and ethical issues raised by CDHC. He describes how other countries have achieved universal access to high-quality health care at lower cost, without relying extensively on cost sharing, and he concludes with a proposal for how the United States might do the same, incorporating aspects of CDHC while recognizing its limitations.
States are increasingly important players in the current efforts to reform U.S. health care, as the federal government withdraws from this responsibility. Robert B. Hackey analyzes the varied routes states have taken in reformulating health care policy and provides a road map of what specific strategies work and why.
In this comparative case study, Hackey focuses on four states—Massachusetts, New Hampshire, New York and Rhode Island—that have had markedly different experiences with regulating health care over the past two decades. Hackey's detailed comparisons show how the states' policies changed over time, moving from regulatory to market-oriented solutions, and examines which policy programs appear best poised to meet the future.
Hackey uses regime theory to explain how the states' policy choices concerning cost control and entry regulation were shaped by the prevailing political culture and institution of each state. He concludes that the autonomy of state government form special interests is vital to the successful adoption, implementation and outcome of state initiatives.
Rethinking Health Care Policy offers policymakers, planners and specialists useful insights into the politics of state regulation and into future directions for health care reform.
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