Greenwald, Howard P.,

Health care in the United States : organization, management, and policy / Howard P. Greenwald. - Second edition. - 1 online resource (xvii, 302 pages) : illustrations (some color) -

Includes bibliographical references and index.

Table of Contents
Tables and Figures x

Preface to the Second Edition xii

The Author xv

Acknowledgments xvi

About the Companion Website xvii

Part 1 The System and Its Tasks

1 Understanding Health Care 3

Health Care as a National Concern 3

Health Care Objectives and Goals 6

Essential Challenges in Health Care 7

Public Trust and Professional Ethics 10

Three Perspectives on Management and Policy 11

2 The U.S. Health Care System: Features, Development, and Controversies 16

The U.S. Health Care System’s Magnitude 16

Uniqueness of the System 16

American Values and Health Care 25

Controversies in U.S. Health Care 29

3 Major Health Problems in Modern Society 35

Conceptions of Health and Disease 35

The Causes of Disease 41

Epidemiology: The Science of the Denominator 46

Health, Illness, and Demand for Services 54

Future Threats to Human Health 57

4 Human Behavior, Health, and Health Care 62

The Behavioral Dimension 62

The Concept of the Sick Role 62

Health Risk Behavior 63

Use of Health Services 71

Adverse Patient Behavior 75

Health Literacy and Cultural Competence 77

Complementary and Alternative Medicine 80

Consumer Preferences and Health Care Marketing 81

Part 2 Means of Delivery

5 Health Care Organizations 89

The Importance of Organizations in Health Care 89

Health Service Industry Sectors 90

Ambulatory Care Organizations 93

The Hospital 98

The Managed Care Organization 108

Other Health Care Organizations 109

Organizational Management in Health Care 113

6 The Health Care Labor Force 118

Health Care Labor Force Issues 118

The Concept of Professionalism 119

History, Background, and Challenges in Three Key Fields 121

Clinicians as Managers 129

The Health Care Labor Force: Facts and Figures 130

Labor Force Dynamics in the Health Professions 133

Professional Oversight and Discipline 138

7 Health Care Expenditures, Financing, and Insurance 143

Funding Sources and Expenditures 143

Health Care Costs: A Global Issue 146

Cost Accelerators in the United States 148

The Health Insurance Landscape 151

Additional Insurance Concepts and Terminology 161

Medicare Specifics and Issues 162

Affordable Care Act Coverage Expansion 164

Uninsurance: The Continuing Problem 165

Continuing Issues 167

8 Biomedical Research and Program Evaluation 172

The Importance of Research 172

Principles of Experimental Design 172

Modern Research Designs 174

Outcome Measures 179

Program Evaluation 180

Cost-Effectiveness and Cost-Benefit Analysis 182

The Social and Economic Context of Research 183

Science Gone Wrong: Error, Distortion, and Fraud 187

Part 3 Paths Forward

9 Innovations and Outcomes 195

Importance and Background 195

Innovation Assessment: Measurement and Methods 198

Selective Contracting 201

Cost Sharing 202

Managed Care 204

Diagnosis Related Groups 206

The Affordable Care Act (ACA) 207

Other Innovations 210

Total Effects and Unanticipated Consequences 212

10 Disease Prevention and Health Promotion 217

The Importance of Prevention 217

Preventable Morbidity and Mortality 218

Prevention Dimensions 220

Prevention in Practice 221

Evidence-Based Prevention 224

Health Promotion 225

Challenges to Prevention 229

Does Prevention Save Money? 236

The Future: Prevention and U.S. Health Care 238

11 Government, Policy, and Politics in Health Care 243

Government and Health Care in the United States 243

The Need for Government Participation 244

How Government Shapes Health Care 246

Politics: The Driver of Policy 254

Political Money 258

Effective Health Care Politics: Case Studies in Legislation 259

The Case Against Government in Health Care 265

12 Looking into the Future 269

Challenges to Reform 269

Non-U.S. Health Care Systems 272

A System to Emulate? A Closer Look at Canada 276

Future Reform in the United States 279

Glossary 284

Abbreviations 290

Index 291

"The chapters to follow have been written as a textbook in health care management and policy. The book may serve as an introduction to problems and issues in U.S. health care for people entering related professional fields. It is also intended for use by people already experienced in a specialized area of management, policy, or patient care for attaining perspective on the system as a whole. Every day, millions of Americans encounter challenges in locating and paying for services and obtaining care of the highest quality for themselves or their loved ones. Many are led to wonder how health care operates "behind the scenes," why an essential service should involve such difficulties, and what steps might be taken towards the system's improvement. This book is intended primarily for students. But it is also a factual resource for citizens, clinicians, and officials seeking to better understand and improve health care in the United States. For no reader will the material presented here be entirely new. Without exception, everyone reading these pages will have experienced health care as a consumer. It is hoped that this book will help readers of any background see their experience as part of a large, complex, and ever-changing system. An improved view of where the reader's experience fits within this firmament will enable her or him to better render direct service, manage human and material resources, influence policy, and utilize health care for his or her own needs"--


About the Author
Howard P. Greenwald, PhD, is Professor at the Sol Price School of Public Policy, University of Southern California. He received his doctorate in sociology from the University of California at Berkeley.

9781119812210 9781119812234 1119812232 9781119812579 1119812577 9781119812227 1119812224

10.1002/9781119812234 doi


Medical policy--United States.
Medical economics--United States.
Medical care--United States.


Electronic books.

RA395.A3 / G74 2022

362.10973