American Studies

There has never been a more compelling time to adopt a system of care based on population health management. The COVID-19 pandemic revealed substantial health disparities. The population is aging, and the Medicare insolvency crisis is looming. Now is the time to move away from fee-for-service care and toward an approach that prioritizes quality, outcomes, and affordability for all populations.In Caring for Our Communities: A Blueprint for Better Outcomes in Population Health, author Mark Angelo shares the expertise he has acquired as a senior administrator of a large accountable care organization and a leader in population health and palliative medicine. He provides tactical guidance for developing effective population health programs and explores value-based care models. He also uses real-world examples and industry experts' views to clarify the concepts underlying value-based initiatives and shares how data and analytics are used to assess the health and needs of a population.Caring for Our Communities provides a road map for creating an equitable, outcomes-focused system, using the right resources to nurture the health of our communities.

In Health Care Policy and Practice: A Biopsychosocial Perspective, Moniz and Gorin guide students through the development of the American health care system: what it is, what the policies are, and how students can influence them. Part I focuses on recent history and reforms; Part II examines the system's structure and policies; and Part III explores policy analysis and advocacy, and disparities in health based on demographics and inequities in access to care. The book concludes with a discussion of the impact of social factors on health and health status. This new, fifth edition has been fully updated to include the Trump administration's efforts to "repeal and replace" the Affordable Care Act (ACA) and to integrate content throughout the text on the impact of the ACA in recent years. In addition, new content on health disparities for the LGBTQ community has been added.

Although the United States spends almost one-fifth of all its resources funding healthcare, the American system continues to be dogged by persistent inequities in the treatment of racial and ethnic minorities and women. Invisible Visits analyzes how middle-class Black women navigate the complexities of dealing with doctors in this environment. It challenges the idea that race and gender discrimination - particularly in healthcare settings - is a thing of the past, and questions the persistent myth that discrimination only affects poor racial minorities. In so doing, the book expands our understanding of how Black middle-class women are treated when they go to the doctor, why they continue to face inequities in securing proper medical care, and what strategies they use to fight for the best treatment (as well as the consequential toll on their health). Based on original research, the author shines a light on how women perceive the persistently negative stereotypes that follow them into the exam room, and proceeds to illustrate that simply providing more cultural-competency or anti-bias training to doctors will not be enough to overcome the problem. For Americans to truly address these challenges, the deeply embedded discrimination in our prized institutions - including those in the healthcare sector - must be acknowledged.

It may not be a quick fix, but this concrete action plan for reform can create a less costly and healthier system for all. Beyond the outrageous expense, the quality of care varies wildly, and millions of Americans can't get care when they need it. This is bad for patients, bad for doctors, and bad for business. In The Long Fix, physician and health care CEO Vivian S. Lee, MD, cuts to the heart of the health care crisis. The problem with the way medicine is practiced, she explains, is not so much who's paying, it's what we are paying for. Insurers, employers, the government, and individuals pay for every procedure, prescription, and lab test, whether or not it makes us better--and that is both backward and dangerous. Dr. Lee proposes turning the way we receive care completely inside out. When doctors, hospitals, and pharmaceutical companies are paid to keep people healthy, care improves and costs decrease. Lee shares inspiring examples of how this has been done, from physicians' practices that prioritize preventative care, to hospitals that adapt lessons from manufacturing plants to make them safer, to health care organizations that share online how much care costs and how well each physician is caring for patients. Using clear and compelling language, Dr. Lee paints a picture that is both realistic and optimistic. It may not be a quick fix, but her concrete action plan for reform--for employers and other payers, patients, clinicians, and policy makers--can reinvent health care, and create a less costly, more efficient, and healthier system for all.

This volume is being published at a critical time in U.S. history and serves as a comprehensive and much-needed update to what is known about Latinx health. As both the United States and Latinx subgroups experience demographic shifts, it is critical to examine the current epidemiology of Latinx health, as well as the factors influencing the health and well-being of this growing population. Chapters in this book, written by highly respected experts, illuminate the diversity of the Latinx population and provide strategies to mitigate many of the challenges they face, including challenges related to migrating to new destinations. The book is designed to enrich dialogue around the multilevel determinants of Latinx health and concludes with a call to action for increased culturally congruent, theoretically informed and participatory Latinx health research. The book also encourages the mentorship and growth of early career and junior investigators to conduct research on Latinx health issues. A selection of the perspectives included among the chapters: Chronic disease and mental health issues in Latinx populations Substance use among Latinx adolescents in the United States Physical and intellectual and developmental disabilities in Latinx populations Health insurance reform and the Latinx population Immigration enforcement policies and Latinx health Research priorities for Latinx sexual and gender minorities Racial and ethnic discrimination, intersectionality, acculturation, and Latinx health New and Emerging Issues in Latinx Health is an invaluable compendium that provides a foundation of understanding Latinx health and well-being and guides future research and practice. The book is essential for researchers, practitioners, and students in the fields of public health and the social sciences including community and health psychology, health administration and policy, community health education, medical anthropology, medical sociology, population health, and preventive medicine. Moreover, the chapters in this volume are also relevant for federal, state, and local agencies, including health departments, and other Latinx- and immigrant-serving community organizations.

A POLITICAL PROVOCATION FROM A PAIR OF PHYSICIANS WRITING OUTSIDE THEIR LANEAmericans care about their health. Americans pay lots of money in hopes of maintaining their health. So why are Americans so unhealthy? The reason is simple: as a country, the United States overinvests in medical care at the expense of the social, economic, and cultural forces that produce health. The rise of medicine as a cornerstone of American life and culture has coincided with a social and political devaluation of factors demonstrated to mean more to our vitality than anything else - influences like where we live, work, and play; livable wages that create opportunity for healthy living; and gender and racial equity. In Pained, physicians Michael Stein and Sandro Galea push the conversation around American health where it belongs: toward matters of class, money, and culture. Across more than 50 essays and data illustrations, Pained casts a light on how the structural components of everyday life - like school, housing, police, even cell phones - ultimately determine who gets to be healthy in today's America. In doing so, it makes a case for reframing our political discourse in less myopic, more effectual terms.Accessible and surprising, political but not partisan, Pained is the urgent, uncomfortable conversation that American needs in this challenging moment. It will delight and infuriate readers of all political stripes.

Beyond political posturing and industry quick-fixes, why is the American health care system so difficult to reform? Health care reform efforts are difficult to achieve and have been historically undermined by their narrow scope. In The Present Illness, Martin F. Shapiro, MD, PhD, MPH, weaves together history, sociology, extensive research, and his own experiences as a physician to explore the broad range of afflictions impairing US health care and explains why we won't be able to fix the system without making significant changes across society. With a sharp eye and ready humor, Shapiro dissects the ways all groups participating--clinicians and their organizations, medical schools and their faculty, hospitals and clinical corporations, scientists and the National Institutes of Health, insurers and manufacturers, governments and their policies, and also patients and the public--shape and reinforce a dysfunctional system. Shapiro identifies three major problems stymieing reform: commodification of care; values, expectations, unmet needs, attitudes, and personal limitations of participants; and toxic relationships and communication among these groups. Shapiro lays out a sweeping agenda of concrete actions to address the many factors contributing to the system's failings. Highlighting the interconnectedness of both the problems and potential solutions, he warns that piecemeal reform efforts will continue to be undermined by those who believe they have something to gain from the status quo. Although overhauling our health care system is daunting, Shapiro nonetheless concludes that we must push forward with a far more comprehensive effort in all sectors of health care and throughout society to create a system that is humane, effective, and just.

From a giant of health care policy, an engaging and enlightening account of why American health care is so expensive--and why it doesn't have to be Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of the U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it. Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America pays for health care, dispelling the confusion, ignorance, myths, and misinformation that hinder effective reform.

Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base--as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems--important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20 % of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.

The inside story of how Big Pharma's relentless pursuit of ever-higher profits corrupts medical knowledge--misleading doctors, misdirecting American health care, and harming our health. The United States spends an excess $1.5 trillion annually on health care compared to other wealthy countries--yet the amount of time that Americans live in good health ranks a lowly 68th in the world. At the heart of the problem is Big Pharma, which funds most clinical trials and therefore controls the research agenda, withholds the real data from those trials as corporate secrets, and shapes most of the information relied upon by health care professionals. In this no-holds-barred exposé, Dr. John Abramson--one of the foremost experts on the drug industry's deceptive tactics--combines patient stories with what he learned during many years of serving as an expert in national drug litigation to reveal the tangled web of financial interests at the heart of the dysfunction in our health-care system. For example, one of pharma's best-kept secrets is that the peer reviewers charged with ensuring the accuracy and completeness of the clinical trial reports published in medical journals do not even have access to complete data and must rely on manufacturer-influenced summaries. Likewise for the experts who write the clinical practice guidelines that define our standards of care. The result of years of research and privileged access to the inner workings of the U.S. medical-industrial complex, Sickening shines a light on the dark underbelly of American health care--and presents a path toward genuine reform.

The term "patient safety" rose to popularity in the late nineties, as the medical community - in particular, physicians working in nonmedical and administrative capacities - sought to raise awareness of the tens of thousands of deaths in the US attributed to medical errors each year. But what was causing these medical errors? And what made these accidents to rise to epidemic levels, seemingly overnight? Still Not Safe is the story of the rise of the patient-safety movement - and how an "epidemic" of medical errors was derived from a reality that didn't support such a characterization. Physician Robert Wears and organizational theorist Kathleen Sutcliffe trace the origins of patient safety to the emergence of market trends that challenged the place of doctors in the larger medical ecosystem: the rise in medical litigation and physicians' aversion to risk; institutional changes in the organization and control of healthcare; and a bureaucratic movement to "rationalize" medical practice - to make a hospital run like a factory. If these social factors challenged the place of practitioners, then the patient-safety movement provided a means for readjustment. In spite of relatively constant rates of medical errors in the preceding decades, the "epidemic" was announced in 1999 with the publication of the Institute of Medicine report To Err Is Human; the reforms that followed came to be dominated by the very professions it set out to reform. Weaving together narratives from medicine, psychology, philosophy, and human performance, Still Not Safe offers a counterpoint to the presiding, doctor-centric narrative of contemporary American medicine. It is certain to raise difficult, important questions around the state of our healthcare system - and provide an opening note for other challenging conversations.

An Essential Guide to the Processes and Operational Complexities of the U.S. Healthcare System A Doody's Core Title for 2024 & 2023! The U.S. Healthcare Ecosystem serves as an expert navigator through the complicated and often confusing environment where healthcare payers, healthcare providers, and producers of healthcare technologies all interact. This thorough resource provides expert insight and analysis of employer-based health insurance, pharmacy benefits, the major professions, healthcare consolidation, drug discovery and development, biotechnology, and much more. Packed with timely examples and filled with illustrations, The U.S. Healthcare Ecosystem will inspire you to think more critically about the business of healthcare and make informed assessments.   Features: Includes often neglected topics impacting healthcare delivery such as employer-based health insurance, pharmacy benefits, healthcare consolidation, and biotechnology Highly readable and single-authored by a Wharton Professor who has taught health care delivery and management for over 20 years Filled to the brim with helpful diagrams, charts and tables - nearly 350 figures complement the text Every chapter ends with a helpful Summary and Questions to Ponder

Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients (TM) and providers (TM) attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider "patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.

A riveting exposé of medical debt collection in America, and the profound financial and physical costs eroding patient trust in medicineFor the crime of falling sick without wealth, Americans today face lawsuits, wage garnishment, home foreclosure, and even jail time.Yet who really profits from aggressive medical debt collection? And how does this predatory system affect patients and doctors responsible for their care?Your Money or Your Life reveals how medical debt collection became a multibillion-dollar industry and how everyday Americans are made to pay the price. Emergency physician and historian Luke Messac weaves patient stories into a history of law, finance, and medicine to show how debt and debt collection are destroying the foundational trust between doctors and patients at the heart of American healthcare. The fight to stop aggressive collection tactics has brought together people from all corners of the political spectrum. But if we want to better protect the sick from financial ruin, we have to understand how we got here.With wit and clarity, Your Money or Your Life asks us all to rethink the purpose of our modern healthcare system and consider whom it truly serves.