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28 books match the query 'Health care reform'

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Beyond Obamacare

James S. House is Angus Campbell Distinguished University Professor Emeritus of Survey Research, Public Policy, and Sociology at the University of Michigan, Ann Arbor.

Russell Sage Foundation, 2015

Health care spending in the United States today is approaching 20 percent of GDP, yet levels of U.S. population health have been declining for decades relative to other wealthy and even some developing nations. How is it possible that the United States, which spends more than any other nation on health care and insurance, now has a population markedly less healthy than those of many other nations? Sociologist and public health expert James S. House analyzes this paradoxical crisis, offering surprising new explanations for how and why the United States has fallen into this trap. In Beyond Obamacare, House shows that health care reforms, including the Affordable Care Act, cannot resolve this crisis because they do not focus on the underlying causes for the nation’s poor health outcomes, which are largely social, economic, environmental, psychological, and behavioral. House demonstrates that the problems of our broken health care and insurance system are interconnected with our large and growing social disparities in education, income, and other conditions of life and work, and calls for a complete reorientation of how we think about health. He concludes that we need to move away from our misguided and almost exclusive focus on biomedical determinants of health, and to place more emphasis on addressing social, economic, and other inequalities. House’s review of the evidence suggests that the landmark Affordable Care Act of 2010, and even universal access to health care, are likely to yield only marginal improvements in population health or in reducing health care expenditures. In order to rein in spending and improve population health, we need to refocus health policy from the supply side—which makes more and presumably better health care available to more citizens—to the demand side—which would improve population health though means other than health care and insurance, thereby reducing need and spending for health care. House shows how policies that provide expanded educational opportunities, more and better jobs and income, reduced racial-ethnic discrimination and segregation, and improved neighborhood quality enhance population health and quality of life as well as help curb health spending. He recommends redirecting funds from inefficient supply-side health care measures toward broader social initiatives focused on education, income support, civil rights, housing and neighborhoods, and other reforms, which can be paid for from savings in expenditures for health care and insurance. A provocative reconceptualization of health in America, Beyond Obamacare looks past partisan debates to show how cost-efficient and effective health policies begin with more comprehensive social policy reforms.

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Cultivating Health

Los Angeles Women and Public Health Reform

Koslow, Jennifer

Rutgers University Press, 2009

At the dawn of the Progressive Era, when America was experiencing an industrial boom, many working families often ate contaminated food, lived in decaying urban tenements, and had little access to medical care. In a city that demanded change, Los Angeles women, rather than city officials, championed the call to action.

Cultivating Health, an interdisciplinary chronicle, details women's impact on remaking health policy, despite the absence of government support. Combining primary source and municipal archival research with comfortable prose, Jennifer Lisa Koslow explores community nursing, housing reform, milk sanitation, childbirth, and the campaign against venereal disease in late nineteenth and early twentieth century Los Angeles. She demonstrates how women implemented health care reform and civic programs while laying the groundwork for a successful transition of responsibility back to government.

Koslow highlights women's home health care and urban policy-changing accomplishments and pays tribute to what would become the model for similar service-based systems in other American centers.

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Financing Medicaid

Federalism and the Growth of America's Health Care Safety Net

Shanna Rose

University of Michigan Press, 2013

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.

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Flatlined

Resuscitating American Medicine

Clifton, Guy L

Rutgers University Press, 2008

Flatlined lifts the veil of secrecy on twenty-first century health care and delves into the realities of good people caught in a bad medical system. Dr. Guy L. Clifton, a practitioner as well as a policy advocate, reveals first-hand accounts of needless tragedy, such as the young man who died after a car wreck for lack of a bed in a qualified hospital and the surgeon who was dejected by the scarcity of resources needed to enable him to perform heart surgery on an uninsured man.

Arguing that a lack of coordinated care and quality medical practice benchmarks result in high levels of redundancy and ineffectiveness, Clifton proposes that the key to reducing health care costs, improving quality, and financially protecting the uninsured, is to reduce wastefulness, and offers a solution for achieving success.

Flatlined sounds the warning call: By 2018 Medicare and Medicaid will consume about one-third of the federal budget. American businesses now pay three times as much of their payroll for health care as global competitors, expected to worsen as health care grows at twice the rate of the U.S. economy. Based on his years of experience in policy and medicine, Clifton offers an attainable solution through the development of an American Medical Quality System.

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Health Care Reform and the Battle for the Body Politic

Dan Beauchamp

Temple University Press, 1996

"Dan Beauchamp's important book melds a personal odyssey, an abiding, passionate commitment to one version of comprehensive health reform, and highly disciplined political analysis. His years in the Cuomo Administration provide him with rich insight into how that scion of liberalism inched toward, but ultimately shied away from, major health reform in the Empire State. His provocative assessment of the missed opportunities represented by the Clinton health plan also deserves the attention of any serious student of health politics and policy." --Frank J. Thompson, Professor of Dean, Graduate School of Public Affairs, State University of New York at Albany While most studies of health care reform have focused on solving the market's failure, controlling costs, or providing universal access, Dan E. Beauchamp adeptly discusses health care reform as a strategy for dealing with the failures of politics--not just the failures of the health care market. As the former Deputy Commissioner for Policy and Planning for the New York State Department of Health, Beauchamp presents a revelatory first-person narrative about his work to develop a universal health care and insurance plan for New York State. His enlightening personal account includes discussions of his efforts to develop a national model of the New York plan for Mario Cuomo (during the period when the governor considered running for the Democratic nomination for president), and his perceptive critique of the failed Clinton plan for reform. Beauchamp gets beyond topics like global budgets, rate-setting, and managed competition to outline the idea of health plans as a means for the public to come together in a way that will change forever the way we think about health care, which he calls "the battle for the body politic." A large part of engaging in the "battle," he argues, involves addressing and resolving racial and class divisions that have always underscored America's political reality. Ultimately, Beauchamp argues for a reform that would promote health and social equality, one that would change and strengthen our social awareness of health care as a common good. "Dan Beauchamp is a singular and important voice in the ongoing health care debate. Instead of focusing on the technical details of health reform, he spins a compelling personal narrative, entices the reader into the truly important questions: How do health plans work politically? How can they change the way we think about health, health care and ourselves as a country? While economists focus on financing schemes, and bioethicists search for underlying values, Beauchamp probes how a health care system shapes our politics and affects our experience of who we are as Americans. His book is exceedingly valuable; it reveals just how much is at stake in health care reform." --Larry R. Churchill, Professor and Chair, Department of Social Medicine, University of North Carolina at Chapel Hill

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Health Care at Risk

A Critique of the Consumer-Driven Movement

Timothy Stoltzfus Jost

Duke University Press, 2007

In Health Care at Risk Timothy Stoltzfus Jost, a leading expert in health law, weighs in on consumer-driven health care (CDHC), which many policymakers and analysts are promoting as the answer to the severe access, cost, and quality problems afflicting the American health care system. The idea behind CDHC is simple: consumers should be encouraged to save for medical care with health savings accounts, rely on these accounts to cover routine medical expenses, and turn to insurance only to cover catastrophic medical events. Advocates of consumer-driven health care believe that if consumers are spending their own money on medical care, they will purchase only services with real value to them. Jost contends that supporters of CDHC rely on oversimplified ideas about health care, health care systems, economics, and human nature.

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.

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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.

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Markets and Medicine

The Politics of Health Care Reform in Britain, Germany, and the United States

Susan Giaimo

University of Michigan Press, 2002

Are advanced industrialized countries converging on a market response to reform their systems of social protection? By comparing the health care reform experiences of Britain, Germany, and the United States in the 1990s, Susan Giaimo explores how countries pursue diverse policy responses and how such variations reflect distinctive institutions, actors, and reform politics in each country.

In Britain, the Thatcher government's plan to inject a market into the state-administered national health service resulted in a circumscribed experiment orchestrated from above. In Germany, the Kohl government sought to repair defects in the corporatist arrangement with doctors and insurers, thus limiting the market experiment and designing it to enhance the solidarity of the national health insurance system. In the United States, private market actors foiled Clinton's bid to expand the federal government's role in the private health care system through managed competition and national insurance. But market reform continued, albeit led by private employers and with government officials playing a reactive role. Actors and institutions surrounding the existing health care settlement in each country created particular reform politics that either militated against or fostered the deployment of competition.

The finding that major transformations are occurring in private as well as public systems of social protection suggests that studies of social policy change expand their focus beyond statutory welfare state programs. The book will interest political scientists and policymakers concerned with welfare state reform in advanced industrial societies; social scientists interested in the changing balance among state, market, and societal interests in governance; and health policy researchers, health policymakers, and health care professionals.

Susan Giaimo is an independent scholar. She completed her Ph.D. in Political Science at the University of Wisconsin-Madison. She also earned an MSc in Politics from the London School of Economics and Political Science, with the Politics and Government of Western Europe as the branch of study. After completing her doctorate, she was a postdoctoral fellow in the Robert Wood Johnson Foundation Scholars in Health Policy Research Program, University of California at Berkeley, and the Robert Bosch Foundation Scholars Program in Comparative Public Policy and Comparative Institutions, American Institute for Contemporary German Studies, Johns Hopkins University. She taught in the Political Science Department at Massachusetts Institute of Technology for five years. During that period she won the Society for the Advancement of Socio-Economics Founder's Prize for "Adapting the Welfare State: The Case of Health Care Reform in Britain, Germany, and the United States," a paper she coauthored with Philip Manow. She has also worked for health maintenance organizations (HMOs) and medical practices in the United States.

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Medicaid And The Limits of State Health Reform

Michael S. Sparer

Temple University Press, 1996

With the defeat of national health reform, many liberals have looked to the states as the source of health policy innovation. At the same time, many in the new Republican majority and several governors also support increased state control. In contrast, Michael S. Sparer convincingly argues that states by themselves can neither satisfy the liberal hope for universal coverage nor the conservative hope for cost containment. He also points to two critical drawbacks to a state-dominated health care system: the variation in coverage among states and the intergovernmental tension that would inevitably accompany such a change.

Supporting his arguments, Sparer analyzes the contradictions in operations and policies between the New York and California Medicaid programs. For instance, why does New York spend an average of $7,286 on its Medicaid beneficiaries and California an average of $2,801? The answer, the author suggests, is rooted in bureaucratic politics. California officials enjoy significant bureaucratic autonomy, while the system in New York is fragmented, decentralized, and interest-group dominated. The book supports this conclusion by exploring nursing home and home care policy, hospital care policy, and managed care policy in the two states. Sparer's dissection of the consequences of state-based reform make a persuasive case for national health insurance.

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Medicare Reform

Issues and Answers

Edited by Andrew J. Rettenmaier and Thomas R. Saving

University of Chicago Press, 1999

In 1965, landmark legislation established the national Medicare system as a means of insuring access to medical care for all elderly citizens. Today, rocketing medical costs combined with a rapidly aging population have thrown the Medicare system off balance, moving it perilously close to financial crisis. Medicare already accounts for 2.65 percent of gross domestic product, and by the year 2030 that share is expected to more than double. Further, the trust fund dedicated to Medicare hospitalization coverage is expected to be depleted by 2008. Clearly, Medicare as we know it cannot endure much longer without either imposing a massive tax burden or dissolving altogether under its own financial strain.

Medicare Reform—the first volume in a new series sponsored by the George Bush School of Government and Public Policy at Texas A&M University—tackles the current Medicare predicament head-on, delving into the fundamental issues surrounding the reorganization of the system: whether to allocate Medicare's growing financial load to current workers in the form of higher taxes, shift the onus to future generations, or shortchange both the expectations and care of present recipients by substantially cutting benefits. This volume assembles a group of the most highly respected analysts of health issues to consider the economic forces impacting the surging health care market.

Written for the general reader and offering innovative ideas for policy revision along with critical new data on health care economics, this comprehensive volume provides a timely and thoughtful deliberation on the precarious future of Medicare.

"Because, as Richard Weaver once said, 'ideas have consequences,' this book is important. It will not end the debate on Medicare, but it will begin it."—Phil Gramm, from the foreword

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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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National Health Care

Lessons for the United States and Canada

Jonathan Lemco, Editor

University of Michigan Press, 1994

The American health care system is at the center of current policy debates. There is widespread dissatisfaction with the existing system as costs escalate and more Americans join the ranks of the uninsured and underinsured. This volume brings together scholars who consider the extent to which Canada's national health care system can or cannot provide lessons for the United States. National Health Care attempts to provide a balanced, policy-focused discussion on many of the most prominent health care reform strategies. The contributors clearly demonstrate that no one health care system is perfect but that meaningful reforms are possible. Since the issues associated with health care reform will affect all of us in North America, it is incumbent on our policymakers to pay particular attention to the most pragmatic and effective policy prescriptions. The evidence suggests that voters in Canada, and even more voters in the United. States, will reward candidates who meet their health care expectations.Contributors are Morris L. Barer. Luciano Bozzini, David W. Conklin, Raisa B. Deber, Robert G. Evans, David U. Himmelstein, Jonathan Lemeo, Theodore R. Marmor, Jerry L. Mashaw, Edward Neuschler, Frank W. Puffer, Barry Seidman, Lee Soderstrom. Paul W. Sperduto, Malcolm Taylor, and Steffie Woolhandler.

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Policy Challenges in Modern Health Care

Edited by David Mechanic, Lynn B. Rogut, David Colby, and James R. Knickman

Rutgers University Press, 2005

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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Progressive Mothers, Better Babies

Race, Public Health, and the State in Brazil, 1850-1945

By Okezi T. Otovo

University of Texas Press, 2016

In Bahia, Brazil, the decades following emancipation saw the rise of reformers who sought to reshape the citizenry by educating Bahian women in methods for raising “better babies.” The idealized Brazilian would be better equipped to contribute to the labor and organizational needs of a modern nation. Backed by many physicians, politicians, and intellectuals, the resulting welfare programs for mothers and children mirrored complex debates about Brazilian nationality. Examining the local and national contours of this movement, Progressive Mothers, Better Babies investigates families, medical institutions, state-building, and social stratification to trace the resulting policies, which gathered momentum in the aftermath of abolition (1888) and the declaration of the First Republic (1889), culminating during the administration of President Getúlio Vargas (1930–1945).

Exploring the cultural discourses on race, gender, and poverty that permeated medical knowledge and the public health system for almost a century, Okezi T. Otovo draws on extensive archival research to reconstruct the implications for Bahia, where family patronage politics governed poor women’s labor as the mothers who were the focus of medical interventions were often the nannies and nursemaids of society’s wealthier families. The book reveals key transition points as the state of Bahia transformed from being a place where poor families could expect few social services to becoming the home of numerous programs targeting the poorest mothers and their children. Negotiating crucial questions of identity, this history sheds new light on larger debates about Brazil’s past and future.

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Protecting American Health Care Consumers

Eleanor DeArman Kinney

Duke University Press, 2002

Despite the attention to the problem of protecting the health care interests of Americans, there is little consensus on what should be done politically or otherwise to address this problem. In Protecting American Health Care Consumers Eleanor DeArman Kinney, a nationally regarded expert on health policy and law, tackles the serious and ongoing debate among state and federal policymakers, health care providers, third-party payers, and consumers about how to provide procedural justice to patients in the present health care climate.
To promote and ensure consumer protection in an increasingly adversarial and complicated health-care culture, Kinney first analyzes the procedures by which consumer concerns are presently discerned and resolved and then explains why these systems are unsatisfactory. She also discusses problematic procedures for making coverage policy and quality standards and proposes reforms in a variety of processes that would enable all consumers, including the uninsured, to influence key policies and standards and also to raise concerns and obtain appropriate remedies.
As the first comprehensive treatment of administrative procedures in American health plans and other such institutions, Protecting American Health Care Consumers will be welcomed by state and federal policymakers, managed care executives, and lawyers charged with designing and implementing protections for consumers in public and private health plans.

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Rx for Health Care Reform

Ken Terry

Vanderbilt University Press, 2007

In this readable and well-researched book, Ken Terry analyzes the current state of health care reform and finds it wanting. Instead of tackling the core problems in our failing system, he argues, politicians, insurance executives, and health care leaders have embraced ideologically driven initiatives that pursue impractical objectives or will take too long to bear fruit. Among these are such widely hailed trends as disease management, pay for performance, cost and price ìtransparency,î consumer-directed care, and health information technology, none of which will reverse the rising tide of health spending. What is creating this nightmare scenario, according to Terry, is the sheer profitability of the health care industry. Insurers, physicians, hospitals, pharmaceutical companies, and device manufacturers are all striving to maximize their profits, and there is no effective competition or regulation to restrain them. Only a complete overhaul of our system for financing and delivering health care can get us out of this mess, the author maintains. In the second half of his book, he presents a bold vision of how to do this: First, he says, all primary care physicians should join group practices that are large enough to take financial responsibility for professional services. And second, competition among those physician groups, based on cost and quality, should replace competition among health plans. There should be only one government-regulated insurer per region, he says, and it should have no role in managing care.

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Side Effects and Complications

The Economic Consequences of Health-Care Reform

Casey B. Mulligan

University of Chicago Press, 2015

The Affordable Care Act will have a dangerous effect on the American economy. That may sound like a political stance, but it’s a conclusion directly borne out by economic forecasts. In Side Effects and Complications, preeminent labor economist Casey B. Mulligan brings to light the dire economic realities that have been lost in the ideological debate over the ACA, and he offers an eye-opening, accessible look at the price American citizens will pay because of it.

Looking specifically at the labor market, Mulligan reveals how the costs of health care under the ACA actually create implicit taxes on individuals, and how increased costs to employers will be passed on to their employees. Mulligan shows how, as a result, millions of workers will find themselves in a situation in which full-time work, adjusted for the expense of health care, will actually pay less than part-time work or even not working at all. Analyzing the incentives—or lack thereof—for people to earn more by working more, Mulligan offers projections on how many hours people will work and how productively they will work, as well as how much they will spend in general. Using the powerful tools of economics, he then illustrates the detrimental consequences on overall employment in the near future.

Drawing on extensive knowledge of the labor market and the economic theories at its foundation, Side Effects and Complications offers a crucial wake-up call about the risks the ACA poses for the economy. Plainly laying out the true costs of the ACA, Mulligan’s grounded and thorough predictions are something that workers and policy makers cannot afford to ignore.

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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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TennCare, One State's Experiment with Medicaid Expansion

Christina Juris Bennett

Vanderbilt University Press, 2014

A history of the struggle among competing stakeholders in one of the oldest and most controversial experiments in US health care policy, a precursor to Obamacare. In 1993, Tennessee launched a reform initiative designed to simultaneously expand the proportion of residents with health insurance and curtail cost increases. It was guided by principles that nearly match those that guided the creation of the Affordable Care Act, also known as Obamacare. Like the ACA, TennCare used corporations, rather than a single government payer, to implement the plan, and it relied on a mix of managed care, market competition, and government regulation.

While many states cut back on their Medicaid enrollments from 1993 to 2001, TennCare grew from 750,000 to 1.47 million enrollees. The state was less successful in controlling costs, however. Each major stakeholder group (the state, the managed care organizations, the providers, and the enrollees and their advocates) pushed back against parts of the state's strategy that adversely affected their interests, and they eventually dismantled the mechanisms of cost constraint.

The author lays out the four stakeholder perspectives for each period in the history of TennCare and provides a link to difficult-to-access primary documents.

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The Dilemma of Federal Mental Health Policy

Radical Reform or Incremental Change?

Grob, Gerald N

Rutgers University Press, 2006

Severe and persistent mental illnesses are among the most pressing health and social problems in contemporary America. Recent estimates suggest that more than three million people in the U.S. have disabling mental disorders. The direct and indirect costs of their care exceed 180 billion dollars nationwide each year. Effective treatments and services exist, but many such individuals do not have access to these services because of limitations in mental health and social policies.

For nearly two centuries Americans have grappled with the question of how to serve individuals with severe disorders. During the second half of the twentieth century, mental health policy advocates reacted against institutional care, claiming that community care and treatment would improve the lives of people with mental disorders. Once the exclusive province of state governments, the federal government moved into this policy arena after World War II. Policies ranged from those focused on mental disorders, to those that focused more broadly on health and social welfare.

In this book, Gerald N. Grob and Howard H. Goldman trace how an ever-changing coalition of mental health experts, patients' rights activists, and politicians envisioned this community-based system of psychiatric services. The authors show how policies shifted emphasis from radical reform to incremental change. Many have benefited from this shift, but many are left without the care they require.

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The Five Health Frontiers

A New Radical Blueprint

Christopher Thomas

Pluto Press, 2022

'A brilliant exposé' - Danny Dorling

Covid-19 has exposed the limits of a neoliberal public health orthodoxy. But instead of imagining radical change, the left is stuck in a rearguard action focused on defending the NHS from the wrecking ball of privatization.

Public health expert Christopher Thomas argues that we must emerge from Covid-19 on the offensive - with a bold, new vision for our health and care. He maps out five new frontiers for public health and imagines how we can move beyond safeguarding what we have to a radical expansion of the principles put forward by Aneurin Bevan, the founder of the NHS, over 70 years ago.

Beyond recalibrating our approach to healthcare services, his blueprint includes a fundamental redesign of our economy through Public Health Net Zero; a bold new universal public health service fit to address the real causes of ill health; and a major recalibration in the efforts against the epidemiological reality of an era of pandemics.

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The Future of Healthcare Reform in the United States

Edited by Anup Malani and Michael H. Schill

University of Chicago Press, 2015

In the years since the passage of the Patient Protection and Affordable Care Act (PPACA, or, colloquially, Obamacare), most of the discussion about it has been political. But as the politics fade and the law's many complex provisions take effect, a much more interesting question begins to emerge: How will the law affect the American health care regime in the coming years and decades?

This book brings together fourteen leading scholars from the fields of law, economics, medicine, and public health to answer that question. Taking discipline-specific views, they offer their analyses and predictions for the future of health care reform. By turns thought-provoking, counterintuitive, and even contradictory, the essays together cover the landscape of positions on the PPACA's prospects. Some see efficiency growth and moderating prices; others fear a strangling bureaucracy and spiraling costs. The result is a deeply informed, richly substantive discussion that will trouble settled positions and lay the groundwork for analysis and assessment as the law's effects begin to become clear.

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The Healthiest City

Milwaukee and the Politics of Health Reform

Judith W. Leavitt

University of Wisconsin Press, 1996

Between 1850 and 1900, Milwaukee’s rapid population growth also gave rise to high death rates, infectious diseases, crowded housing, filthy streets, inadequate water supplies, and incredible stench. The Healthiest City shows how a coalition of reform groups brought about community education and municipal action to achieve for Milwaukee the title of “the healthiest city” by the 1930s. This highly praised book reminds us that cutting funds and regulations for preserving public health results in inconvenience, illness, and even death.
“A major work. . . . Leavitt focuses on three illustrative issues—smallpox, garbage, and milk, representing the larger areas of infectious disease, sanitation, and food control.”—Norman Gevitz, Journal of the American Medical Association
“Leavitt’s research provides additional evidence . . . that improvements in sanitation, living conditions, and diet contributed more to the overall decline in mortality rates than advances in medical practice. . . . A solid contribution to the history of urban reform politics and public health.”—Jo Ann Carrigan, Journal of American History

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The Medical Delivery Business

Health Reform, Childbirth, and the Economic Order

Perkins, Barbara Bridgman

Rutgers University Press, 2004

Americans at the end of the twentieth century worried that managed care had fundamentally transformed the character of medicine. In The Medical Delivery Business, Barbara Bridgman Perkins uses examples drawn from maternal and infant care to argue that the business approach in medicine is not a new development. Health care reformers throughout the century looked to industrial, corporate, and commercial enterprises as models for the institutions, specialties, and technological strategies that defined modern medicine.

In the case of perinatal care, the business model emphasized specialized over primary care, encouraged the use of surgical and technological procedures, and unnecessarily turned childbirth into an intensive care situation. Active management techniques, for example, encouraged obstetricians to accelerate labor with oxytocin to augment their productivity. Despite the achievements of the childbirth and women’s health movement in the 1970s, aggressive medical intervention has remained the birth experience for millions of American women (and their babies) every year.

The Medical Delivery Business challenges the conventional view that a dose of the market is good for medicine. While Perkins is sympathetic to the goals of progressive and feminist reformers, she questions whether their strategies will succeed in making medicine more equitable and effective. She argues that the medical care system itself needs to be fundamentally "re-formed," and the reforms must be based on democracy, caring, and social justice as well as economics.

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The Politics of Health Care Reform

Lessons from the Past, Prospects for the Future

James A. Morone and Gary S. Belkin, eds.

Duke University Press, 1994

This distinguished collection stands out from the recent flurry of books on health reform by its sustained and sophisticated analysis of the political dimension. In The Politics of Health Care Reform, some of America’s best-known political scientists, historians, and legal scholars make sense of our most turbulent policy issue. They dig below the jargon and minutiae to explore the enduring questions of American politics, government reform, and health care.
The Politics of Health Care Reform explains how successful reforms occur in the United States and shows what is unique about health care issues. Theoretically informed, politically astute, historically nuanced, this volume takes an inventory of our health policy infrastructure. Here is an account of the institutions, ideas, and interests that shape health policy in the 1990s: Congress, the federal courts, interest groups, state governments, the public bureaucracy, business (large and small), the insurance industry, the medical profession. The volume offers a fresh look at such critical matters as public opinion, the politics of race and gender, and the lessons we can draw from other nations.
The Politics of Health Care Reform is the definitive collection of political science essays about health care. Expanded from two special issues of the Journal of Health Politics, Policy and Law, the most prominent scholarly journal in the field it helped create, this collection will enliven the present debate over health reform and instruct everyone who is concerned about the future of American health care.

Contributors. Lawrence Brown, Robert Evans, William Glaser, Colleen Grogan, Robert Hackey, Lawrence Jacobs, Nancy Jecker, Taeku Lee, Joan Lehman, David McBride, Ted Marmor, Cathie Jo Martin, James A. Morone, Mark Peterson, David Rochefort, Rand Rosenblatt, David Rothman, Joan Ruttenberg, Mark Schlesinger, Theda Skocpol, Michael Sparer, Deborah Stone, Kenneth Thorpe

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