Healing the Fragmented U.S. Healthcare System

Through a systems perspective, this insightful book challenges the current state of healthcare in the United States, arguing for overarching reforms that would lead ultimately to universal healthcare coverage across the country. Written by the president of the board of trustees of a rural hospital, the book highlights the chronic issues facing American healthcare today, namely high costs, poor health outcomes, excessive health inequalities, and a lack of trust. It uses systems thinking principles - used in hospitals themselves to improve efficiency, quality, and safety of care - to show how the fragmented system could be transformed by addressing these issues holistically. The book also gives suggestions for rebuilding trust, respect, and mutual cooperation, issues which are also critical in healing the current system. Grounded in the author's direct experience in facing the challenges of dealing with a fragmented system in America today, this perceptive book will interest graduate students in healthcare administration, policy, or leadership programs, as well as scholars in these and related fields.

Barbara J. Sowada is president of the board of trustees of a rural hospital. She has a Ph.D. in nutrition from Colorado State University. She lives in southwest Wyoming. This is her second book about healthcare reform.

Introduction. 1. Review of Systems: The Construction of the U.S. Healthcare System. 2. Efficiency. 3. Fifty Years of Cost Reductions Increased Costs. 4. Creative Disruptors. 5. Effectiveness. 6. The U.S. Healthcare System Is Out of Date. 7. Health Equity. 8. Social Capital and Social Cohesion. 9. Choices. 10. Healing.