Understanding Health Care in America

This book examines the current state of American health care using a social science lens to focus on the interdependent, intercultural, economic, and communication aspects of access and delivery. This text explores how the cultures of health care organizations, health professions, governments, and capitalism, as well as communication, all contribute to a disease-focused, economically driven, technology-centered health care system. It seeks to understand 21st century health care from a macro-level view based on historical realizations and the current plethora of interdependent, but self-serving realities that provide few, if any, incentives for organizational collaboration and change. The fact that the most expensive health care system in the world does not provide the healthiest outcomes is a driving force in this exploration. By reflecting on American values and beliefs regarding health care from philosophical, clinical, communication, and cost perspectives, this text is designed to encourage an organizational transformation at every level, from government to providers to patients. This comprehensive survey is an important guide for those studying, or working in, health care professions, as well as health care policy and administration. It should also be of interest to any reader who seeks to better understand U.S. health care policy from social science, economic, and/or health communication perspectives.

Michael Pagano is an Associate Professor in the Department of Communication at Fairfield University, Connecticut. After serving as an Army corpsman in Vietnam, he became a Physician Assistant-Certified (PA-C). While working in Emergency Departments, he went to graduate school and earned an MA in English and a PhD in Communication with a focus in health communication. Over the past 40 years he has practiced as a PA-C and combined patient care with his passion for teaching and his interest in exploring health communication from consumer-provider, provider education, and health care organizational communication perspectives. Currently, he teaches a wide variety of undergraduate and graduate health, organizational, and interpersonal communication courses, including interdisciplinary health studies courses for health professions students.

1.Introduction: culture, capitalism, and communication. Section 1: The Impact of Organizational Culture on Health Care in America. 2.Physician Culture. 3.Nursing Culture. 4.Health Care Organization (nonprovider, nongovernment) Culture. 5.Health Consumer Culture. Section 2: The Impact of Capitalism on Health Care in America. 6.Capitalism and Health Care- The Government's Role. 7.Capitalism and Health Care- Health insurance. 8.Capitalism and Health Care-Technology and specialization. 9.Capitalism and Health Care-Pharmaceutical and device manufacturers. Section 3: The Impact of Communication in Healthcare in America. 10.Communication and Health Care. Section 4: Implications for Health Care Reform. 11.Understanding Health Care in America-The Future.