Analyzing Form, Function, and Financing of the U.S. Health Care System

This book tells the story of the U.S. health care system by using a narrative approach identifying function rather than the more common data-driven focus on structure. It presents policy decisions we have made about our health care system and analyzes some of their consequences to better understand the choices we have. Its four major sections cover the basics of the U.S. health care system, a description of its form, financing of the system, and major health care reform efforts.

Dr. Paula Stamps Duston earned her PhD degree from the School of Public Health at the University of Oklahoma. She currently is teaching in the Commonwealth Honors College at the University of Massachusetts and serves as the graduate program director for public health in the university's School of Public Health and Health Sciences. She is best known for her research in developing validated scales to measure the level of satisfaction of direct care providers, including both nurses and physicians. Her nurse satisfaction instrument, the Index of Work Satisfaction (IWS), is the most widely used in the field and is recommended by the American Nursing Association and JCAHCO for use as a quality indicator.

INTRODUCTION: SETTING THE CONTEXT. Definitions of Health and Illness. Public Health: Defining Determinants of Health. Health Status Indicators. Role of Culture in the Organization of Health Care Delivery Systems. Political and Philosophical Values That Influence the U.S. Health Care System. FUNCTIONAL DESCRIPTION OF THE U.S. HEALTH AND MEDICAL CARE SYSTEM. Do We Have a System? A Functional Analysis. People Who Make the Medical Care System Go: The Workforce. Hospitals. Ambulatory Care: Functions, Structures, and Services. Other Components of the Medical Care System. POLITICAL AND ECONOMIC VALUES AND HEALTH CARE FINANCING. Health Economics 101: Do Health Care Goods/Services Follow Standard Economic Rules? From Economics to Health Policy and Regulation. Health Care Financing: Health Insurance. Health Insurance: Two Conceptual Models. The Payment Function: Money Moving through the System. Why Does Medical Care Cost So Much and What Can We Do about It? HEALTH CARE REFORM IN THE UNITED STATES: TARGETED PROGRAMS AND CONSEQUENCES. Health Care Reform: Past as Prologue to Present. Taking Care of the Elderly: Medicare. Taking Care of the Poor: Medicaid. Taking Care of Almost Everybody Else. A Persistent Problem: Racial and Ethnic Disparities in Health Outcomes. Alternative Models for Health Care Systems: International Perspectives. References.