The Economic Evolution of American Health Care

The Economic Evolution of American Health Care
Author: David Dranove
Publisher: Princeton University Press
Total Pages: 220
Release: 2009-01-10
Genre: Medical
ISBN: 1400824680

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The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.

The Economic Evolution of American Health Care

The Economic Evolution of American Health Care
Author: David Dranove
Publisher: Princeton University Press
Total Pages: 224
Release: 2002-10-13
Genre: Medical
ISBN: 9780691102535

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The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.

Code Red

Code Red
Author: David Dranove
Publisher: Princeton University Press
Total Pages: 290
Release: 2009-04-11
Genre: Business & Economics
ISBN: 1400829623

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The U.S. healthcare system is in critical condition--but this should come as a surprise to no one. Yet until now the solutions proposed have been unworkable, pie-in-the-sky plans that have had little chance of becoming law and even less of succeeding. In Code Red, David Dranove, one of the nation's leading experts on the economics of healthcare, proposes a set of feasible solutions that address access, efficiency, and quality. Dranove offers pragmatic remedies, some of them controversial, all of them crucially needed to restore the system to vitality. He pays special attention to the plight of the uninsured, and proposes a new direction that promises to make premier healthcare for all Americans a national reality. Setting his story against the backdrop of healthcare in the United States from the early twentieth century to the present day, he reveals why a century of private and public sector efforts to reform the ailing system have largely failed. He draws on insights from economics to diagnose the root causes of rising costs and diminishing access to quality care, such as inadequate information, perverse incentives, and malfunctioning insurance markets. Dranove describes the ongoing efforts to revive the system--including the rise of consumerism, the quality movement, and initiatives to expand access--and argues that these efforts are doomed to fail without more fundamental, systemic, market-based reforms. Code Red lays the foundation for a thriving healthcare system and is indispensable for anyone trying to make sense of the thorny issues of healthcare reform.

The History and Evolution of Healthcare in America

The History and Evolution of Healthcare in America
Author: Thomas W. Loker
Publisher: iUniverse
Total Pages: 402
Release: 2012-04
Genre: Business & Economics
ISBN: 1475900732

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From the beginning of mankind, health and health issues have played a major role in life, but the issues and care have evolved enormously from the time when the first settlers set foot in America to the present. In The History and Evolution of Healthcare in America, author Thomas W. Loker provides a historical perspective on the state of healthcare and offers fresh views on changes to Obamacare. Insightful and thorough, The History and Evolution of Healthcare in America offers a look at - what healthcare was like at the birth of the nation; - how the practice of providing healthcare has changed for both caregivers and receivers; - why the process has become so corrupt and expensive; - what needs to happen to provide both choice and effective and efficient care for all; - where we need to most focus efforts to get the biggest change; - what is needed to get control over this out-of-control situation. Loker narrates a journey through the history of American healthcare-where we've been, how we arrived where we are today, and determine where we might need to go tomorrow. The history illustrates how parts of the problem have been solved in the past and helps us understand what might be necessary to solve our remaining problems in the future.

American Healthcare

American Healthcare
Author: Peter Hilsenrath, PhD
Publisher: CRC Press
Total Pages: 162
Release: 2022-05-24
Genre: Business & Economics
ISBN: 1000587258

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Selected by the Association of University Programs in Health Administration for the Bugbee-Falk Book Award Is the health sector a curse or a blessing? The American health sector now accounts for a fifth of the economy. American healthcare spending per capita far exceeds that of other developed countries. Yet our health, as measured by life expectancy and infant mortality, is poor by comparison with the developed world. Other measures of quality including hospital-acquired infection are too common. Healthcare costs financially cripple households despite advances associated with the Affordable Care Act. There is widespread dissatisfaction with the American healthcare system and support for more change. It is also the case that the health sector has been a leader in the evolution of the American economy. Economic development is driven by innovative technology. We tend to applaud new technology and the improvement it brings to our lives. Important recent technologies often grow rapidly and faster than the wider economy. This leads to larger shares of the economy. Yet there is considerable apprehension about costs and economic impact of health spending. This book details important health sector institutions and uniquely, explores linkages between healthcare and broader economic growth. The book addresses asymmetric information between providers and consumers as well as between insurers and beneficiaries. There is a focus on monopoly power in labor markets which contributes to inefficiencies in the system. The author also discusses cost-effectiveness and allocative efficiency as well as emphasizing productivity and its relationship to the wider economy.

The Price We Pay

The Price We Pay
Author: Marty Makary
Publisher: Bloomsbury Publishing USA
Total Pages: 305
Release: 2019-09-10
Genre: Health & Fitness
ISBN: 1635574129

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New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.

Understanding Healthcare Economics

Understanding Healthcare Economics
Author: Jeanne Wendel, PHD
Publisher: Taylor & Francis
Total Pages: 190
Release: 2017-11-22
Genre: Business & Economics
ISBN: 135175761X

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Healthcare economics is a topic of increasing importance due to the substantial changes that are expected to radically alter the way Americans obtain and finance healthcare. Understanding Healthcare Economics, 2nd Edition provides an evidence-based framework to help practitioners comprehend the changes already underway in our nation’s healthcare system. It presents important economic facts and explains the economic concepts needed to understand the implications of these facts. It also summarizes the results of recent empirical studies on access, cost, and quality problems in today’s healthcare system. The material is presented in two sections. Section 1 focuses on the healthcare access, cost and quality issues that create pressures for change in health policy. The first edition was completed just as the Patient Protection and Affordable Care Act (PPACA) was debated and passed. This new edition updates the information about access, cost, and quality issues. It also discusses the pressure for change that led to the passage of the PPACA, evidence that shaped the construction of the act, evidence on the impacts of the PPACA, and evidence on the pressures for future changes. Section 2 focuses on changes that are underway including: changes in the Medicare payment system; new types of healthcare delivery organizations such as ACOs and patient-centered medical homes. It also discusses the current efforts to help patients build health such as wellness programs and disease management programs. And finally, health information technology will be discussed. The new edition will maintain the current structure; however each chapter will be updated to discuss post-PPACA evidence on each type of type. In addition to the updates previously mentioned, the authors will present a series of data explorations to several chapters. Most of the new data explorations present summarized statistical information based on de-identified data from one hospital electronic data system. These data explorations serve two purposes. First, they illustrate the impacts of the pressures for change – and some of the changes – on healthcare providers. For example, the data illustrates the financial impact of pre-PPACA uncompensated care. Second, explanation of the data will require explanations of standard coding systems that are used nationwide (DRGs, CPT, ICD) codes. Other data explorations provide detail about other sources of data useful for health policy analysis, and for healthcare providers and insurers.

An Introduction to the US Health Care Industry

An Introduction to the US Health Care Industry
Author: David S. Guzick
Publisher: JHU Press
Total Pages: 372
Release: 2020-10-13
Genre: Medical
ISBN: 1421438666

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Why does US health care have such high costs and poor outcomes? Dr. David S. Guzick offers this critique of the American health care industry and argues that it could work more effectively by rebalancing care, cost, and access. For decades, the United States has been faced with a puzzling problem: Despite spending much more money per capita on health care than any other developed nation, its population suffers from notoriously poorer health. In comparison with 10 other high-income nations, in fact, the US has the lowest life expectancy at birth, the highest rates of infant and neonatal mortality, and the most inequitable access to physicians when adjusted for need. In An Introduction to the US Health Care Industry, Dr. David S. Guzick takes an in-depth look at this troubling issue. Bringing to bear his unique background as a physician, economist, former University of Rochester medical school dean, and former president of the University of Florida Health System, Dr. Guzick shows that what we commonly refer to as the US health care "system" is actually an industry forged by a unique collection of self-interested and disjointed stakeholders. He argues that the assumptions underlying well-functioning markets do not align with health care. The resulting market imperfections, combined with entrenched industry stakeholders, have led to a significant imbalance of care, cost, and access. Using a nontechnical framework, Dr. Guzick introduces readers to the economic principles behind the function—and dysfunction—of our health care industry. He shows how the market-based approach could be expected to remedy these problems while detailing the realities of imperfections, regulations, and wealth inequality on those functions. He also analyzes how this industry developed, presenting the conceptual underpinnings of the health care industry while detailing its history and tracing the creation and entrenchment of the current federation of key stakeholders—government, insurance companies, hospitals, doctors, employers, and drug and device manufacturers. In the final section of the book, Dr. Guzick looks to the future, describing the prevention, innovation, and alternative financing models that could help to rebalance the priorities of care, cost, and access that Americans need. An online supplement on COVID-19 is available, as is a discussion guide for instructors. To access this supplemental material, please visit www.jhupbooks.press.jhu.edu.

Access to Health Care in America

Access to Health Care in America
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 240
Release: 1993-02-01
Genre: Medical
ISBN: 0309047420

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Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.

The American Health Care Paradox

The American Health Care Paradox
Author: Elizabeth Bradley
Publisher: Public Affairs
Total Pages: 274
Release: 2013-11-05
Genre: Political Science
ISBN: 1610392094

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Considers why U.S. society is believed to be less healthy in spite of disproportionate spending on health care, identifying a lack of social services, outdated care allocations, and a resistance to government programs as the problem.