Health Care Reform

This study of US health care describes how its reorganization has been set by developments in the national and international political economies, and shows how these developments have affected the social and economic transformations.

In this book, international teams of physicians, nurses, public health experts, philosophers, theologians, politicians, administrators, social workers, and lawyers articulate four basic goals of medicine and examine them in light of the cultural, political, and economic pressures under which medicine functions. Discussing prevention of disease, relief of suffering, care of the ill, and avoidance of premature death, contributors clearly demonstrate the importance of clarifying the purposes of medicine before attempting to change economic and organizational systems.

This volume examines the two models of health care reform, managed competition and internal markets, that are increasingly becoming the dominant paradigm in European and North American policy by considering the experience of reform in the U.S., Canada, the U.K, the Netherlands and New Zealand, the author analyzes which reform model is likely to efficiently ensure access for all citizens to a comprehensive range of services and draws out the implications for policy.

This book offers a systematic review of major issues and trends in health care policy, including those related to physical health and disease trends, mental and behavioral health concerns, reorganizing the U.S. health system, and managed care and health care personnel. Kronenfeld addresses the problems, challenges, issues and trends in the policies that determine the role and future of health care in the United States.

To thrive in the highly competitive health care marketplace, organizations must consistently demonstrate their ability to contain costs, improve quality, and increase customer satisfaction. In Raising Standards in American Health Care, nationally acclaimed health care management expert V. Clay Sherman shows managers and executives how to utilize the powerful management force of strategic standardization to overcome the most common barriers to these challenges-and increase competitive advantage. Raising Standards in American Health Care translates proven Fortune 500 business strategies into pathways toward operational excellence for health care organizations. The book offers a review of the important lessons learned from corporate business giants-including Southwest Airlines, Wal-Mart, McDonald''s, and others-who have forged their paths to performance excellence by mastering the art of strategic standardization. Raising Standards in American Health Care draws on the most current developments in modern management practice and theory such as the balanced scorecard, stretch goals, and the focused health care factory. In addition, the book''s concepts are enhanced by a wealth of helpful materials including descriptive tables, charts, illustrations, internet information sources, and suggested discussion questions that can be used as a springboard for action. Sherman clearly demonstrates that superior outcomes and competitive advantage can be achieved as organizations aggressively raise the standards of American health care. In this landmark book, Sherman outlines a working model of strategic standardization and offers reliable methods to guide health care leaders in their quest to demonstrate measurable change. In clear terms, the author shows how to achieve standardization of defined clinical protocols, administrative and non-clinical functions, as well as standardization in equipment, procedures, professional practice, and organization performances. This innovative organizational model shows leaders how to keep their promise to deliver the highest standards of care far beyond the existing health care performance standards promoted by JCAHO and NCQA-as well as revealing insight into emerging alternative standards that promise to uniformly raise future care levels. Transform Your Health Care Organization by Changing the Standards That Govern It"Sherman gives us many embraceable ideas to work with, and his message remains solid: our health care organizations must be transformed by standardizing best practices. This is a refreshing, even exciting approach to the very foundation of setting new standards for health care excellence."_William G. Gonzalez, chief health system officer, Spectrum Health, Grand Rapids, MI; Top 100 Hospitals Winner 1994, 1995, 1998; America''s Top 100 Integrated Health Care Systems Winner 1998"Sherman has once again brought his unique insight and vision to improving hospital and health care system management in meeting today''s challenges of delivering quality health care to better serve patients."_Terry Townsend, president and CEO, The Association of Texas Hospitals and Health Care Organizations"Sherman is sending America''s health care leadership a tough message, and it''s on target. As an industry we need to do a better job for our patients, our physicians, and our associates, and Clay''s book tells us how. A must read for tomorrow''s leader."_Richard R. Risk, president and CEO, Advocate Health Care System, Chicago, IL"This book challenged me as it will the entire health care industry. I found myself applauding Dr. Sherman''s insightful analyses and practical how-to solutions. Employer coalitions . . . are in a position to . . . raise the standards of management and ultimately the care that patients receive."_Gregg O. Lehman, president and CEO, National Business Coalition on Health"Raising Standards in American Health Care ranks among the most challenging, practical business management books I''ve ever read. Grea

Shelton explains how the power of talk defeated comprehensive health care reform in 1994, and how it continues to affect society today. The 1994 call for reform fits into a century long context of concern. Reform was defeated once again in 1994 by the discursive power of big government. The ripples of the health care reform debate influence ethical decisions, research interests, and overall social behavior today.

Americans at the end of the twentieth century worried that managed care had fundamentally transformed the character of medicine. In The Medical Delivery Business, Barbara Bridgman Perkins uses examples drawn from maternal and infant care to argue that the business approach in medicine is not a new development. Health care reformers throughout the century looked to industrial, corporate, and commercial enterprises as models for the institutions, specialties, and technological strategies that defined modern medicine. In the case of perinatal care, the business model emphasized specialized over primary care, encouraged the use of surgical procedures, and unnecessarily turned childbirth into an intensive care situation. Active management techniques, for example, encouraged obstetricians to use labor-accelerating treatments such as oxytocin in attempts to augment their productivity. Despite the achievements of the women's health movement in the 1970s, aggressive medical intervention has remained the birth experience for millions of American women (and their babies) every year. The Medical Delivery Business challenges the conventional view that a dose of the market is good for medicine. But while Perkins is sympathetic to the goals of progressive and feminist reformers, she questions whether their methods will succeed in making medicine more equitable and effective. She argues that the medical care system itself needs to be "reformed, " and the reform process must include democracy, caring, and social justice as well as economic theory.

Discussing laws in the current research funding decision process, the author suggests ways to improve future funding of health research systems. Chapters recount ways of raising funds, the tragic way authorities improperly introduced diptheria immunization, consideration of how the peer review system evolved in response to massive infusion of funds in the 1940s, and the status quo generating a climate conducive to ethics violations, among others.

This fascinating work will be an invaluable tool to researchers, health care workers, members of government agencies and those in charitable organizations that support health research, as well as to anyone interested in current trends in this area, including patients.