Book Description
This fifth edition of the classic text, Strategic Management of Health Care Organizations, introduces strategic thinking, strategic planning, and strategic momentum to advanced undergraduate and graduate students as well as practitioners in the field of health care. It demonstrates how strategic managers can become strategic thinkers with the crucial skills to evaluate the changing environment, analyze data, question assumptions, and develop new ideas.Swayne, Duncan, and Ginter present methods to develop and document a plan of action through strategic planning and illustrate how, as managers attempt to carry out the strategic plan, they evaluate its success, learn more about what works, and incorporate new strategic thinking into future planning, strategy formulation, and situational analysis. They demonstrate how strategic management "maps " can provide the direction needed for successful implementation.In this new edition, all chapters have been revised and contain new or updated Introductory Incidents and Perspectives. Appendix A has been revised to match the new model of strategic thinking, planning, and managing the strategic momentum. Twenty real-life case studies, including nine new cases and three updated classics, present diverse strategic situations in an accessible manner that enhances the applicability of the concepts for students and professionals.The text is supported by PowerPoint slides and an Instructors ' Manual. Visit www.blackwellpublishing.com/swayne for details.
Customer Reviews:
Both conceptual and practical tools.......2007-04-11
This is an outstanding book. While naturally oriented to strategic management of health care it is also a comprehensive framework to strategic management in general. The book's layout is that of a university textbook but it is also written in an enjoyable style. I read this book as a practitioner and not a formal student and found it extremely readable and helpful. The authors present both conceptual and practical tools for strategic management.
Excellent book.......2006-12-14
I would highly recommend this book. It is easy to read, methodical in approach and provides a balance of relevant theory and application. A useful resource for any healthcare organization expanding its services within existin country or beyond.
Thanks extended to the authors...I look forward to other additions!!!
Excellent Book.......2004-03-03
I was fortunate enough to be a student of Linda Swaynes @ UNC Charlotte. We were the first class to use this book. Not only was Ms. Swayne excellent at what she taught but the book was a tool that explained the theories in nice detail. I continue to use the book as a resource. I am currently a hospital CEO.
Great balance of theory and practice.......2001-11-29
I used this text for a class in health care management. I was impressed by the readability of the text, the incredible amount of information it contained, and the great balance of theory with practical approaches. Many books about management are a bit short in the area of practical tools. This one gives you tools to work with. I used the outline of this book to do a strategic analysis of an organization with which I work. The only significant weakness of the book is the uneven quality of the case studies. These were contributed by outside authors. Some of these are terrific, others are not well written and not so helpful. Hope this gets corrected in the new edition.
A Must for the Novice Planner.......2000-07-27
This comprehensive and yet easily understood text provides the fundamentals of strategic management as it applies to most any health care organization. The authors' experience comes to life in a variety of real examples and cases throughout the text. My background and interest in strategic planning led me to thoroughly examine the step-by-step processes, and I was amazed at both the simplicity and applicability of each. Definetly a text that I will recommend to anyone entering the healthcare industry or strategic planning arenas. Not only was I benefited by the purchase of this text, but had the opportunity to meet these outstanding authors in person during graduate study/research.
Book Description
America's leaders say the economy is strong and getting stronger. But ordinary Americans aren't buying it. They see what the rosy statistics hide: We are all struggling under the weight of terrifying economic instability. No matter how well educated and hard working we are, we know that the bottom can fall out at any moment. Meanwhile, the safety net that once protected us is fast unraveling. With retirement plans in growing jeopardy while health coverage erodes, more and more economic risk is shifting from government and business onto the fragile shoulders of the American family. In The Great Risk Shift, Jacob S. Hacker lays bare this unsettling new economic climate, showing how it has come about, what it is doing to our families, and how we can fight back. Behind this shift, he contends, is the Personal Responsibility Crusade, eagerly embraced by corporate leaders and Republican politicians who speak of a nirvana of economic empowerment, an "ownership society" in which Americans are free to choose. But as Hacker reveals, the result has been quite different: a harsh new world of economic insecurity, in which far too many Americans are free to lose. The book documents how two great pillars of economic security--the family and the workplace--guarantee far less financial stability than they once did. The final leg of economic support--the public and private benefits that workers and families get when economic disaster strikes--has dangerously eroded as political leaders and corporations increasingly cut back protections of our health care, our income security, and our retirement pensions. Hacker concludes by advocating an "insurance and opportunity society" that would safeguard economic security and expand economic opportunity, ensuring that all Americans have the basic financial security they need to reach for and achieve the American Dream. Jacob Hacker brings into focus as never before the pressures that the Great Risk Shift exerts on our pocketbooks and on our lives. Blending powerful human stories, big-picture analysis, and compelling ideas for reform, this remarkable volume will hit a nerve, serving as a rallying point in the vital struggle for economic security in an increasingly uncertain world.
Customer Reviews:
A book to avoid out of respect to fellow taxpayers.......2007-07-30
My book came, and I flipped through it to the last chapter--the REAL reason why I got this book.
While I knew this was a whiny tome about how people are being expected to shoulder more and more of their own social burdens, the title did contain a "how you can fight back" clause.
Well, the so-called "fighting back" involves exchanging one set of social programs for another, for example:
Medicare--of course, this would become Universal Health Care.
Retirement--instead of the accounts we have now, there'd be a Universal Savings account invented to take it's place. This account would cover any kind of savings you can imagine--retirement, college, etc., and would take the place of the ailing Social Security program.
Welfare--another magical account would be created to cover "insecurity": periods of unemployment, downshifting or pay cuts, high inflation, death of a working spouse, etc. to take the place of the existing food stamp, AFDC, unemployment, and/or disability. This would become Universal Insurance.
In short, the author proposes turning America into a highly-taxed, highly-coddled state like Denmark, where all is provided at taxpayer expense (up to 80% of people's pay), and only enough is left for housing, food, gas, and fun (like there'd be any fun on THAT plan!). Where would low-income earners come up with the money for THIS plan?
A quick calculation reveals that we couldn't even afford to pay rent on the 20% of our remaining income, let alone eat and commute, on our middle-class income with this plan.
Taxpayers would contribute to the new accounts, and the government would administer them just like it does now, except that your dollars would have your name on them. Personally, my dollars have my name on them now with my own private accounts, and I'm not paying for something I don't want or need.
There are solutions to these problems in existence now, but few are able to (or choose to) take advantage of them. This plan would take the choice out of the equation, and as far as I can see, doesn't account for the entrepreneurial spirit or self-employment.
If you prefer being self-sufficient, self-reliant, personally responsible, and to live below your means, then stay away from this book. There's nothing here for you except anger. This plan is clearly geared for the mindless sheep out there who want something for nothing, only this plan shows how dear the cost of that something would be--we're already paying up to 40% of our incomes in various taxes just to support people and government now!
What got us into trouble as a country is the fact that government borrows against assets--what's to say the government won't borrow against THESE assets as well? I don't want my accounts to be used as collateral by Uncle Sam.
Where oh where is the INCENTIVE to improve one's self, dear author? This is what got the "have-nots" into the position they're in now!! We've been leading horses to water for so long, they now expect us to bring it to them--and we STILL can't make them drink.
Rising Inequality and Anxiety in America.......2007-05-11
This past fall I heard Jacob Hacker speak about his work in The Great Risk Shift, and I just finally got around to reading the book. What I like about Hacker is that he not only critically examines complex political and societal issues, but he beautifully transforms his conceptions into practical solutions. He doesn't just ask, "What can we do?" He shows us how it can be done.
There are points I agree with in his book and other points I still have some reservations about, but his explanations and reasoning is thoroughly engaging nonetheless. For instance, he proposes a health coverage plan that reemphasizes national concerns about health care security. His proposal places more obligations on employers, which in my opinion, is a plausible expectation if the United States is not willing to adopt a universal health coverage plan. Hacker points out that a large contributor to the rise in bankruptcies is a result of healthcare costs. It's clear that health care insecurity poses great risks to countless Americans from all different placements of the socioeconomic spectrum.
I did face some apprehension and concern regarding his "universal insurance" proposal. This insurance would be designed to protect families in the event of a threatening change in finances and security - for instance a drastic pay decrease. Although I can agree that current job market conditions are very unstable (I myself have faced a drastic pay decrease formerly working in the business sector), I also feel as though we generally have a highly exaggerated sense of materialism and pretentious consumption patterns in America. How will these factors be accounted for when claiming instability and who is entitled to what? Is this where federal money should go when much larger issues regarding our nation's schools, health and extreme poverty are being neglected?
In the Great Risk Shift, Hacker identifies significant points of concern for Americans and the anxieties and rising inequality pressing citizens. With higher and higher concerns, these are questions we will be continually readdressing for years to come. This book proves Hacker always has amazing ideas and great things to say. We can contiunally look forward to his new approaches at examining significant social and political issues.
An attempt to ameliorate economic volatility.......2006-12-16
Although Jacob Hacker exaggerates the level of risk shift in the "Great Risk Shift", he makes some public policy proposals that deserve at least debate if not adoption.
Much of the book is a critique of what he calls "The Personal Responsibility Crusade", which he views as the vehicle for the shift. He tends to overreach at times. Much of the talk I have heard regarding "personal responsibility" was directed about teenage pregnancy or fathers who abandon those they impregnate and/or their children. He is right that "personal responsibility" is sometimes invoked as an argument against certain government social programs but those programs also have very real budgetary concerns that feed most of the efforts to constrain them.
Some of his arguments also seem peculiar. On page 66 Hacker quotes some corporate statements to outline what he calls the "new contract" for workers. "The only job security is a successful business" and "if loyalty means that this company will ignore poor performance, the loyalty is off the table". It is strange he would cite these as somehow new, when were they not true? Even under the "old contract", an unsuccessful business could not offer job security, nor was poor performance ignored.
Hacker makes a compelling case that there is more volatility in incomes (although incomes are generally higher) than in the past. His argument that this was essentially by design is a little less compelling. The three decades after World War II is his (and that of many others) reference point for security. That era can't be recreated. Fortunately, he doesn't resort to the easy (but unwise) option of endorsing trade protectionism, rather he recognizes the globalized economy is a fact of life and suggests a series of measures to mitigate the greater risk born by workers.
For health care coverage, he proposes something called "Medicare Plus", which is a variation on "pay or play" coverage proposals, which require employers to cover their employees or pay into the government plan that covered their employees and everyone outside of the employer market. It isn't really clear why this proposal is better than a universal government run system, other than Hacker seems to think the latter can't be enacted.
He also wants to enhance unemployment insurance and introduce "wage insurance" (for those who are displaced and take a new job that pays less than their previous job).
He also makes a proposal that appears to be novel, what he calls "universal insurance" that would cover families from an array of potential vicissitudes. Both this idea and wage insurance do not have a track record (at least not in the United States) and may not work as well in practice as they might in theory, but they at least deserve discussion.
Strong on describing the issue; Weak on solutions.......2006-11-20
"The Great Risk Shift" has much to recommend it. Hacker cogently explains the way risk has been transferred since the New Deal and Great Society eras (when health care, pensions and the like were seen as collective or corporate responsibility) to individuals. Hacker is at his best in describing the issue -- indemnity medical plans replaced with HMOs or medical savings accounts; defined benefit pension plans replaced with defined contribution plans or 401(k)s; secure, full-time jobs replaced with several part-time jobs cobbled together to make a less-than-full-time salary; broken families who cannot be relied upon for support.
Where the book falters, however, is in its view that every risk should be socialized, at least to some extent. When it comes to catastrophic health risks, many would agree that society should assist. I tend to agree with Hacker that one's medical insurance should not depend on one's employer: some businesses cannot afford adequate insurance for their employees. Likewise, adequate health insurance cannot always be purchased in the market: insurance companies "cherry pick" the healthiest candidates. Thus, Hacker has convinced me that we need some sort of baseline national health insurance, at least for significant or catastrophic illnesses (after all, we have something like it today, as those with health insurance subsidize the emergency room visits of those without it). However, we need to beware of a system with Canada-style rigidity or one which leaves no room for innovations.
Fewer would want to subsidize pensions, however, and Hacker fails to provide a real solution. The problem with defined contribution plans is not that they cannot work, but that they must be adequately funded. They can work if employers contribute enough to them so that employees can have a real pension when they retire. Likewise, individuals should be allowed to put greater amounts of pre-tax income into 401(k)s, and companies should be able to match a greater amount dollar-for-dollar. (This is the type of free-market solution that Hacker does not favor, as he believes individuals are not always able to manage their own 401(k) money.) In any event, Hacker provides no advice for those who find themselves in a defined contribution plan, under the present rules, other than "save more and stop spending on luxuries." As for broken families, that is a trend that predates "the risk shift" and will not be solved by the government. Although Hacker wants more risks to be socialized, it is important to ask what this will cost, and whether we will have a Eurpoean-style economy at the end of it.
Hacker has correctly identified the trend to shift risk from government and corporations to individuals. The question is whether the solutions he suggests will be appropriate and cost-effective. The jury is still out.
Unchallenged Assumptions.......2006-11-16
From his comfortable tenure at Yale, Jacob Hacker offers us an analysis of where things have gone wrong with the American economic system. He identifies three traditional pillars of economic security:
1. The family
2. The workplace
3. Public and private benefits
The first two are under siege. The third one is at risk. Hacker argues that the erosion of that third one - public and private benefits - is not inevitable.
Fair enough. But let's start with the family. The decrease in the stability of the family unit over the years didn't just happen. Victims of the Jerry Springerization of the family - as a mainstream example of how far things have gone askew - have no one to blame but themselves. The freedom to treat family relationships as a disposable commodity is bound to come with some trade-offs. Economic security is one of them. While the erosion of family bonds has been widespread, it is not inevitable either.
As for the other two pillars, they revolve around the ability of commerce to fund them. More corporate profits means more tax revenues - and at least the possibility of more jobs. Without corporate profits, we have no corporations to bash, no corporate profits to tax, and no jobs or benefits, public or private.
Yes, traditional jobs are under siege and traditional benefit programs are morphing. Hacker says we have choices. Yes, we do.
We could, as a society, opt to have more stable jobs, even in an era of increasingly worldwide competition. This is a valid choice. Many parts of Europe have opted for lower overall standards of living in exchange for greater job security and more leisure. Many EU citizens appear willing to tolerate double-digit long-term unemployment rates and higher tax rates in exchange for generous social safety nets.
Of course, we in America have always been looking for the free lunch. Look at U.S. savings rates, which are negative. A critical examination across all socioeconomic classes suggests that the personal saving deficit may have more to do with an insatiable appetite for big-screen televisions, $90 a month cable services, frequent restaurant dining, coiffed hair and acrylic nails, rather than for prudent expenditures on basics like food and shelter.
But by all means, we should welcome Mr. Hacker's debate. It will be useful to make explicit the trade-offs that come to light in the process.
Book Description
Just and Lasting Change presents how to transform communities rapidly and inlocally appropriate ways. Daniel Taylor-Ide and Carl Taylor have been present at key events and worked with key thinkers in dealing with the large forces of inequity, environmental change, and globalization. The approach they have synthesized builds on what has worked over the last century--and can now be implemented rapidly and cost-effectively in many parts of the world. It relies on a three-way partnership of "bottom-up" initiatives from the community level, "top-down" support from government agencies, and "outside-in" ingenuity and objectivity from experts. Based on both a diverse range of case studies--from the earliest attempts to promote social development in India a century ago to current efforts in Tibet, the Peruvian Andes, China, and the American Southwest--and engaging personal experiences, this book describes, step-by-step, how SEED-SCALE can be effectively implemented.
With contributions from leading international experts in community-based development and public health, Just and Lasting Change offers a hopeful description of how people have made a difference in diverse communities around the world and a practical, accessible handbook for those trying to improve the quality of life in underdeveloped communities everywhere.
Customer Reviews:
new Reformation.......2004-06-25
As we watch news reports of the world in chaos and trouble this Book offers not just salve to ease the pain of some of these small communties but also real solution as they being to restore their dignity with justice for all involved.
The Model SEED/Scale is one that I believe should be studied and applied in some of the rural areas, small towns in this part of Southwest Oklahoma. This method is about a reformation of attitude, self-awareness , and possibilites for growth and change bringing the best healthiest new life possible.
I think that Churches could apply the model as well as a way to restoring justice and change withn themselves and within the communities they serve. Revitalization is something that churches in rural arears everywhere talk about I believe this model could be applied with success.
This book should have a broad readership. It could help change the world.
Rev. Bobbie G. McGarey, Southwest Oklahoma Presbyerian Parish Pastor, Frederick, Temple, Walters, Chattanooga, and Grandfield. Oklahoma.
A methodology for durable social change in poor communities.......2003-10-01
The poor communities of the world are, unfortunately, a laboratory for many thousands of mostly failed experiments in how to improve their situation. This important and valuable book builds on decades of practical experience by the authors in the successful, durable transformation of poor communities. The authors' key insights are (1) the necessity for change to be driven by the collaboration of the community, outside experts, and local government; (this may seem obvious, but many projects fail because they treat one of these three groups as an enemy or obstacle rather than a vital element), (2) to have measurable results, (3) to use the power of the community to modify behavior that is an obstacle to success. This book should be read by donors as well as those directly involved in development activities such as community leaders, government officials, and NGO workers.
Book Description
Exceeding $2 trillion annually, health care spending in the United States is growing significantly faster than the national economy. If left unchecked, this health spending crisis will threaten Americans' ability to pay for other essential services. Driven primarily by the cost of benefits promised to seniors under Medicare and Medicaid, federal health expenditures will force lawmakers to make stark policy decisions. In this third volume of Restoring Fiscal Sanity, policy experts suggest ways to slow the growth of federal spending on health care.
Unless federal health spending can be brought under control, Americans will face substantially higher taxes, sharp reductions in other government programs, and cuts in benefits to the elderly. Families, businesses, and communities will be forced to make agonizing choices between health care and other needs. Focusing on policies that do not shift costs to the states or the private sector, the authors of Restoring Fiscal Sanity 2007 suggest reforms in federal programs that have the potential to reduce the growth of spending for the entire health system, increase the efficiency and effectiveness of the care provided, and enhance health outcomes. Drawing on years of government and public policy experience, they stress the need for innovative approaches and cooperation between the private and public sectors.
Customer Reviews:
Great book with HELPFUL advice.......2002-04-17
My mom, sister in law and I are in the process of opening our own daycare center--we find that this book is very helpful-with suggestions on where to get a buisness loan, to how to look for the perfect location to setting up the center itself, it can't be beat. We know nothing about getting a buisness started but we love children and this book reinforced our desire to take the leap into the unknown.
Absolutely wonderful resource!
More of a Center Book.......2001-05-10
This book was not as helpful as I really thought it was going to be. I am opening a daycare in my home and this books speaks quite abit about how to run your own daycare "Center". She talks about finding space, getting a loan, buying "Center" equipment. So if you are going to open your own "Center" then its great - but for all of you who are getting your licence to run it out of your home - try something else - especially for the price of the book ! YIKES!
Great Reading.......2000-06-03
Great Book! It was easy to read and I especially enjoyed the lessons learned from child care professionals referenced throughout the book. Provided practical knowledge on everything from up-start, grand opening to dealing with difficult situations like child abuse. Also get Profitable Child Care by Nan Howkins
Excellent step by step instructions on opening day care.......1999-09-22
this book outlines everything from the concept, agencies, equipment, staff to hire, keeping good staff, parent involvement, and much more. Easy to read and understand instructions.
Book Description
First published in 2002, AIDS in the Twenty-First Century met with widespread praise from researchers and policy makers. This edition is fully revised to take account of the latest facts and developments in the field. All statistics and evidence have been updated and their meanings reconsidered. Latest developments in vaccines, anti-retroviral treatments and microbicides are discussed along with information about the President's Emergency Plan for AIDS Relief and The Global Fund to Fight AIDS, Tuberculosis and Malaria.
Customer Reviews:
A rare focus on the social and economic context.......2002-10-23
This is the only book-length exploration of the social and economic context of the the HIV/AIDS epidemics. What comes through is that the authors are not journalists who dashed off a book on AIDS, but longtime researchers, with world-ranging experience.
WHile well documented, it is readable. The next college level course I teach on contemporary issues will surely include this as required reading. My students will thank me for it.
The best comprehensive treatment of HIV/AIDS.......2002-09-06
Tony Barnett and Alan Whieside have done a fantastic job of placing the issue of HIV/AIDS within a comprehensive context. It is easy to read, well researched, thoughtful in it's analysis, and comprehensive - that is, it places the pandemic amidst the global forces that are affecting it and which must be understood if we're to successfully turn the tide. I am recommending it to many of my colleagues! It is the best book I have read to-date on the most challenging crisis facing the human family.
Book Description
Exposing the most controversial, little-known practices of America’s most flawed system, Time magazine’s Pulitzer Prize-winning investigative team pulls back the curtain on the health care industry to explain exactly how things grew so out of control.
Dirty examination and operating rooms in doctor’s offices and hospitals . . . Health care executives pulling in millions in bonuses for denying treatment to the sick . . . More than 100 million people with inadequate or no medical coverage . . . This may sound like the predicament of a third-world nation, but this is America’s health care reality today. The U.S. spends more on health care than any other nation, yet our benefits are shrinking and life expectancy is shorter here than in countries that spend significantly less per capita. Meanwhile, HMOs, pharmaceutical companies, and hospital chains reap tremendous profits, while politicians—beholden to insurers and drug companies—enact legislation for the benefit of the few rather than the many, while the entire system is on the verge of collapse.
In Critical Condition, award-winning investigative journalists Donald L. Barlett and James B. Steele expose the horror of what health care in America has become. They profile patients and doctors trapped by the system and offer startling personal stories that illuminate what’s gone wrong. Doctors tell of being second-guessed and undermined by health care insurers; nurses recount chilling tales of hospital meltdowns; patients explain how they’ve been victimized by a system that is meant to care for them. Drug companies profit by selling pills in the same manner that Madison Avenue sells soap, while Wall Street rakes in billions by building up and then tearing down health care businesses. And politicians pass legislation perpetuating the injustices and out-right fraud the system encourages.
By analyzing the industry and offering an insightful prescription for getting it back on the right track, Critical Condition is an enormously compelling investigative work that addresses the concerns of every American.
Download Description
Exposing the most controversial, little-known practices of America's most flawed system, Time magazine's Pulitzer Prize-winning investigative team pulls back the curtain on the health care industry to explain exactly how things grew so out of control.
Dirty examination and operating rooms in doctor's offices and hospitals…Health care executives pulling in millions in bonuses for denying treatment to the sick…More than 100 million people with inadequate or no medical coverage…This may sound like the predicament of a third-world nation, but this is America's health care reality today. The U.S. spends more on health care than any other nation, yet our benefits are shrinking and life expectancy is shorter here than in countries that spend significantly less per capita. Meanwhile, HMOs, pharmaceutical companies, and hospital chains reap tremendous profits, while politicians—beholden to insurers and drug companies—enact legislation for the benefit of the few rather than the many, while the entire system is on the verge of collapse.
In CRITICAL CONDITION, award-winning investigative journalists Donald L. Barlett and James B. Steele expose the horror of what health care in America has become. They profile patients and doctors trapped by the system and offer startling personal stories that illuminate what's gone wrong. Doctors tell of being second-guessed and undermined by health care insurers; nurses recount chilling tales of hospital meltdowns; patients explain how they've been victimized by a system that is meant to care for them. Drug companies profit by selling pills in the same manner that Madison Avenue sells soap, while Wall Street rakes in billions by building up and then tearing down health care businesses. And politicians pass legislation perpetuating the injustices and out-right fraud the system encourages.
By analyzing the industry and offering an insightful prescription for getting it back on the right track, CRITICAL CONDITION is an enormously compelling investigative work that addresses the concerns of every American.
Customer Reviews:
Has to be the next book you read!!!!!.......2007-07-27
Everybody who is fed up with the current U.S. health care situation needs to take the time to read this book. It is written for the masses who need a general understanding of how this for-profit system is ruining the quality of life of millions of Americans. Especially with the 2008 presidential election in full gear, this book will give you enough basic information about our existing health care system to put the pressure on all of the 2008 presidential candidates to endorse a national single-payer health care system covering all Americans. Finally, putting us on par with every other "developed" and "civilized" nation on Earth. Excellent work by Barrett.
Excellent book.......2007-06-20
I watched Sicko and loved it. I hated the reality it showed. The problem is I didn't want to jump on his bandwagon until I did some more reading on my own.
On some website, someone wrote that they highly recommend this book. I borrowed it from the library.
This takes Sicko and multiplies its intensity by 10. It's too bad the authors couldn't get the power of visuals and sound that movies, like Moore's enjoys. Otherwise this book would HAMMER this country so hard, it would tremble.
If you liked Sicko, but want more, READ THIS BOOK! If you hated Sicko, READ THIS BOOK, to get a dose of reality. Anti-moore fans can't say much after reading this book because Moore has nothing to do with this.
While I would have liked some graphs/charts or some another illustrative, visual way to reinforce the facts, this book is GREAT! Please read it!
Good research, but flawed.......2007-03-22
This seems to be a well-researched book and I think they do an excellent job of exploring the problem of health care in the USA today. In my opinion, however, they don't go far enough in their exploration.
The authors talk about the high cost of medical treatment. There's no denying the expense. I'm aware of more than one time when a patient has received needed care only because family and friends raised the money to pay for it. However, the way that government interference contributes to the jacked up prices is barely mentioned. (An example from a few years ago in the news, in a western state, all insurers were required by law to cover everyone who came to them, even those dying of incurable diseases. As a direct consequence of the new law, the prices of both medical treatment and insurance rates rose dramatically.)
The authors talk about how many pills are marketed and overprescribed (and I agree with them on this), but again, they don't consider in any depth the government's contribution to the problem. The DEA is waging major war on painkillers. Physicians are intimidated into not prescribing needed painkillers. This artificial market control is raising prices, as well as lowering the quality of health care and hurting people who desperately need those drugs. The authors also ignore how very affordable drugs are kept illegal by federal regulation, despite state voters voting to make them legal.
Where they really flounder, however, is when they propose their solution. They give an unconvincing plan of getting the government involved to wisely and charitably make sure everyone gets the competent medical services they need. This seems to me to be more about what government *should* do rather than what it likely would do. The government is a major part of the problem now. How is it going to change and become the solution if it takes direct control?
It seems to me that they haven't thought through their position. For instance, they write:
"Resistance [to our suggested health care reform] would come from health care providers themselves; from insurers, some of whom would go out of business; from some in the U.S. government bureaucracy who would lose control; from the antitax community; from some physicians and individuals who are content with their personal situations, and most of all, from members of Congress who benefit so handsomely from free-market health care."
I was confused by this because of how often they said most of these people were desperate for change. For example, this statement:
"We have a system in such constant turmoil that almost everyone is unhappy--patients, doctors, nurses, aides, technicians. Almost everyone. But for a lucky few, the turmoil is worth a lot of money."
If all but a "lucky few" are unhappy, then why would they resist change? This goes against what they said repeatedly before the chapter on their propopsed remedy, including some compelling anecdotes of these people who'd resist having been disillusioned and alienated from the system as it is. And why would this government that already has control dread losing control by getting even more control? For that matter, if the government is dysfunctional now, why wouldn't it continue to be dysfunctional later? And if their remedy wouldn't add any costs to society but replace existing taxes, then why would antitax people resist it so bitterly? While the antitax folk might resist any taxes, I'm pretty sure they'd rather taxes go for health care than for the wars at home and abroad and the other things that make people ashamed or angry to be forced to pay for.
I also wish they had spent more time considering how health care works in other countries. I'm not sure that the Scandinavean model could work for the USA because of how different the two places are in population and character, but I would've liked more discussion of the possibilities. I was intrigued by what they said about the system in France, but again, they didn't go into details. I'm also interested in hearing more about Thai health care, which I understand is affordable and excellent despite no national coverage (and popular with some Americans who can afford to go there to get it).
In general, I wish that they'd have explored other, already functioning systems more, and looked at why our FDA is so inferior in ethics and practice to its counterparts in other countries, as well as considering in more depth why (or why not) another country's system could work for us.
Also, from their description, it sounds as if health care was good in the USA until Wall Street, supported by their cronies in Congress, took the medical business over. If that is true, why not focus on getting Wall Street out, instead of the government in? Especially given how badly the government has done so far?
Overall, I think this book is important in understanding the problem of health care in the USA today, though not sufficient all by itself. I'm sorry the authors didn't put more thought into proposing solutions for us to get out of this mess.
More than food for thought.......2006-01-04
The book could have been shorter, without a lot of the individual "sob stories", which I know help sensationalize a news article, but made the book drag on for me.
The authors hit the nail on the head when they bring up all the bankruptcies and foreclosures in our country due to health care costs, and also the horrible cost-shifting that gets placed onto the uninsured among us to support the deep discounts that Medicare, Medicaid and now a plethora of insurers have negotiated with providers.
I'm a dentist, and do not participate in plans which would insist on my discounting services to certain groups. If I am going to discount them (and I do) they are to those less fortunate in life financially, and are not determined by someone's age, race, or employer.
The fact that we have a bizarre system where your health care is tied to who you work for is perverse. The fact that this very system drives up costs for uninsured people, while taking more money out of direct health care and more into insurance company administration and profit is sickening.
I don't have the answers to our problem, but I think that this book is the foundation for much dialogue and debate.
The Time Is Now For Health Care Finance Reform!.......2005-08-23
I am running for Congress in Maryland's first district with health care finance reform as my number one priority. This book contained valuable data to help shore up my position. Read this book, make sure you're registered to vote, then let's elect a progressive, reform-minded Democratic majority into Congress!
Visit [...] for information on how to contribute to our campaign for health care finance reform.
Book Description
Lives at Risk identifies 20 myths about health care as delivered in countries that have national health insurance. These myths have gained the status of fact in both the United States and abroad, even though the evidence shows a far different reality. The authors also explore the political and economic climate of the health care system and offer alternatives to the current health care public policies.
Customer Reviews:
A humbling read........2007-10-21
I spent a few months reading various writings on health care systems and trying to clean up the trash heap that is all Wikipedia articles on the topic. I thought I had a good grip on what was going on around the world. I was wrong.
Lives at Risk presents a crystal clear picture of the health care industry in the US, UK, and Canada. It exposes the economic and political factors that have caused decreasing performance and increasing costs in all three countries. Finally, Lives at Risk makes a recommendation for a way to do things better.
This book lays it all out in short, easy chapters supported by copious references for those who want to know more.
Idael Health Care vs. Universal Health Care.......2007-08-11
I learn that Ideal Health Care might be more effective than Univerisal Health Care. In addition, Manage Care & Single Payer Care have too many pit falls.
Health Care .......2007-05-22
Goodman and associates provide a valuable alternative look inside the single-payer, national, universal access health systems of Europe and Canada. This book is long overdue.
I teach a college class in comparative health systems that contrasts the U.S. health system with those of other nations and I use this book as an alternative text. I warn students that it is a polemic; Goodman is on a mission. But since the great mass of academic texts are written by professors in love with Europe and in contempt of the U.S. failure to insure 43 million citizens, this book is a welcome splash of cold water in the face.
The problem is that neither Europe nor the U.S. have solved moral hazard. As long as government, or our tax-subsidized employer, is pre-paying our healthcare, and we can leave your wallet at home and demand all the tests and treatments we are allowed, we are in trouble. It is a big Las Vegas buffet and we are all high-rollers pigging out and over-eating because the tab is on the house.
The result will be disaster in Europe as the aging population increases its demands on a limited supply of younger workers. The disaster in the U.S., with Social Security and Medicare/Medicaid already on track to consume the entire federal budget, is well publicized.
Goodman solution is a revamped Health Savings Account (HSAs) that make each of us responsible.
Whether agree that HSAs are the answer, or prefer some other approach, read this book. Racing to establish universal entitlement is a recipe for univeral disaster.
too much rethoric about free market.......2006-03-03
this is very interesting book providing a huge amount of useful data about different health systems in the world, although the presentation is scattered, irregular and according to the Authors` design, more than to a planned and rational description. Their interpretation of the data provided is not always acceptable. They use the old tactic of attributing something false to the enemy to attack it. They create a "myth" about national health sysems whcih nobody ever stated or believed and they used it to show the weakness of NHS. After completing the book I was even more convinced of the benefit of health systems such as those existing in Europe and in canada compared to the US. Their critique by the Authors might indeed be useful in spotting their limitations ( obody says they are perfect) and correcting them
How Sould Health Care Be Funded And Distributed?.......2005-06-03
Is it the mess we have now, single-payer or something else? Health care and health insurance are not delivered effectively to all Americans in the framework of the free enterprise system. I am a big believer in the markets and the free enterprise system for most services and most products. However, health care and health insurance do not fit for many reasons in free markets. There must be a better way to be care for the health of our people.
Health Insurance Companies cherry pick the most healthy people to insure and try to avoid all persons who do not fit into the category of most healty. Therefore, the folks that need health care the most in order to function properly in our free markets have the most difficult time obtaining health insurance.
Book Description
Nobel laureate Robert Fogel's compelling new study examines health, nutrition and technology from 1700 to 2100. Although throughout most of human history, chronic malnutrition has been the norm, a synergy between improvements in productive technology and human physiology has enabled humans to more than double their average longevity and to increase their body size by over fifty percent over the past three centuries. Larger, healthier humans have contributed to the acceleration of economic growth and technological change, resulting in reduced economic inequality, declining hours of work and a corresponding increase in leisure time. Increased longevity has also brought increased demand for health care. Fogel argues that health care should be viewed as the growth industry of the twenty-first century and systems of financing it should be reformed. His book will be essential reading for all interested in economics, demography, history and health care policy. A professor at the University of Chicago, Robert William Fogel has taught at the University of Rochester, Cambridge University, and Harvard University. He has received numerous awards and prizes for his work, including the Arthur C. Cole Prize (1968), the Schumpeter Prize (1971), the Bancroft Prize (1975), the Gustavus Myers Prize (1990), and the Nobel Memorial Prize in Economic Science (1993). Previous books include Without Consent or Contract: The Rise and Fall of American Slavery (W.W. Norton & Company, 1994) and The Fourth Great Awakening and the Future of Egalitarianism (The University of Chicago Press, 2000).
Customer Reviews:
A glass more than half-full?.......2006-04-16
Given that our vision is so heavily freighted with the moment, ideas of human progress are in short supply lately. Although not an easy ride, economic historian and Nobel laureate Robert William Fogel's survey of the long run, at least in respect to human morbidity, leisure and longevity, provides escape velocity from pressing concerns about war, pandemic, income inequality and the health of the ecosphere. It might be as another noted economist, Alfred Lord Keynes, said in a different context: In the long-run we are all dead. But, the long-run seems to be getting longer.
The Escape from Hunger and Premature Death, 1700-2100 is an extension of Fogel's briefer 1993 Nobel Prize Lecture. It provides a synergistic view of the impact of increasing human environmental control on the demographic, economic and physiological conditions of successive generations over the past 300 years. According to Fogel, the interaction of these forces has over this period, and most dramatically over the last century, brought about a new stage of evolution - non-genetic "techno-physio evolution." He indicates this is evidenced by an unprecedented positive change during this period in caloric intake of about 250%, human body size of over 50%, and an increase in longevity of over 100%. Pointing to the future, Fogel's extrapolation of data over the last 140 years in optimal life circumstances, suggests that centenarians will be common by the last quarter of the 21st century. During the past three centuries there has also been an accompanying substantial decrease in the hours it takes each day to earn one's daily bread and increase in the percentage of discretionary income.
Although this is a "little" book, just 111 pages in the main body, it is densely packed with deep-mine data and illuminating higher-order concepts derived from a lifetime of concentration on economic development, particularly when Fogel was affiliated with the National Bureau of Economic Research as director of its Development of the American Economy Program and subsequently at the University of Chicago as the Charles R. Walgreen Professor of American Institutions and director of the university's Center for Population Economics. Metabolic indices, the thermodynamics of human physiological activity, Waaler curves, in-utero effects on morbidity, protein energy, malnutrition, physiological capital, and Gini ratios are grist for Fogel's mill.
Fogel's treatment of the confluence of technological change, diet, morbidity, work demands, leisure and mortality extends beyond developments in Western society to include the rapid pace of technophysio evolutionary changes in third world countries whose per capita income increases piggybacked on Western innovations, consequently dwarfing the much slower pace of Western improvements a century earlier. In the process of his examination he emphasizes the need to recognize the optimal conditions for human adaptation rather than settle for standards such as daily caloric requirements derived from earlier phases of technophysio evolution. Policy issues in the areas of health care, personal savings and retirement are also discussed in the light of the demographic changes that are occurring.
Some data reported by Fogel and those from other sources are anomalous. For instance, in view of the technophysio evolution particularly of the last 100 years, it seems strange that Dutch males, who were on average about 5'5" in 1860 are now the tallest in the world at about 5'11" while over the same period US men, who were about 5'7" then, are only 5'8" now after the declines of the last few decades. One explanation derives from the widening gap between the rich and the poor in the US (Gini = 45) compared to the greater income equality in the Netherlands (Gini = 30.9). (The Gini coefficient ranges from 1-100 with lower scores representing less income inequality). Also, there are data from millennia ago indicating a decline in average heights in the Eastern Mediterranean in the transition period from the hunter-gatherer economic regime to the first agricultural revolution (11,000 BC - 5000 BC). In John Kolmos (Ed.) Stature, Living Standards and Economic Development (Univ. of Chicago Press, 1994) there are a number of contributions that focus on such issues.
Professor Fogel touches very briefly on in utero, childhood and adolescence effects of economic status on morbidity and mortality, but his comment that "The exact mechanisms by which malnutrition and trauma in utero or in early childhood are transformed into organ dysfunctions are still unclear." (p. 32) is unwarranted. These relationships are detailed extensively in various chapters of the volume by Bruce S. McEwen and H. Maurice Goodman (Eds.) Handbook of Physiology: Coping with the Environment: Vol. IV (Oxford Univ. Press, 2001) for neuroendocrine abnormalities; in D.J.P. Barker's Mothers, Babies and Health in later Life (Churchill Livingstone, 1998) and Fetal Origins of Cardiovascular and Lung Disease (Marcel Dekker, 2001) for specific organ effects; in Peter Gluckman and Mark Hansen's The Fetal Matrix (Cambridge Univ. Press, 2005) for more general morbidity effects; and A.R. Cellura's The Genomic Environment and Niche-Experience (Cedar Springs Press, 2005) for the confluence of genetic influences, economic regimes, ecological niches, caloric intake, stature, morbidity and mortality.
Robert William Fogel's The Escape from Hunger and Premature Death, 1700-2100 is that rare species of research - longitudinal study. Unlike the cross-sectional snapshots whose importance often quickly fades, there is gold in these data mines that is so precious because it is so difficult to find and so hard to get to. It is must reading for those in human biology, medicine and the social sciences who are interested in the issues surrounding human adaptation. It will also appeal to life-long learners drawn to the interface between the biology, economics and history of the human condition.
Book Description
In Crisis of Abundance: Rethinking How We Pay for Health Care, economist Arnold Kling argues that the way we finance health care matches neither the needs of patients nor the way medicine is practiced. The availability of premium medicine, combined with patients who are insulated from costs, means Americans are not getting maximum value per dollar spent. Using basic economic concepts, Kling demonstrates that a greater reliance on private saving and market innovation would eliminate waste, contain health care costs and improve the quality of care. Kling proposes gradually shifting responsibility for health care for the elderly away from taxpayers and back to the individual. The idea of matching the health care funding system to needs is very simple, Kling writes. The very poor and the very sick need help paying for health care. The rest of us do not.
Customer Reviews:
The antidote to Michael Moore.......2007-06-24
Kling does not leap to the quick fix, but he delineates the problems that must be considered in any attempt to restructure the health care system or its funding.
This book is smart and readable, providing the reader with a great overview of parameters to consider.
Another book from CATO.......2007-05-10
Taking out the redundancy, this (about) 100 page book could have been made into a 20 page pamphlet. The real point behind this book: expectation of medicine has been increasing over the years since most people have either private or government sponsored insurance.
Difficult but worth reading.......2007-04-25
For this reader, "Crisis of Abundance" by Arnold Kling was difficult to read. Fortunately, it is very short, under 100 pages. In the end, it was well worth my brief persistence.
Anyone who wants to understand the healthcare crisis in the U.S. would benefit by reading this. The author is an economist, and the book is clearly told from an economic and public policy perspective. His goal was to write this book for the "concerned citizen," while at the same time making it credible to professional economists (p. ix). I rank this book lower than most other reviews because I believe the author partially fails in his attempt to write this book clearly for the concerned citizen.
He makes the point that what ails our national health care system is what he calls "premium medicine" -- or health care spending whose cost exceeds its benefit. He defines "premium medicine" as: "frequent referrals to specialists; extensive use of high-tech diagnostic procedures; and increased numbers and variety of surgeries" (p. 4). "If our high levels of health care spending are the result of so-called premium medicine, we should be demonstrably healthier. Yet when we attempt to examine average longevity at a national level, there seems to be no connection between American's high levels of health care spending and life span." (p. 25)
I found the book most difficult when the author was presenting policy issues. Kling states that his goal is "not to offer a package of solutions. It is to raise the level of understanding of the realities, issues and tradeoffs pertaining to health care policy" (p. 95). Here, for this reader, he succeeded. I now have a far better grasp of why the U.S. spends so much more on health care than other developed nations.
Kling is a libertarian, as is my husband, and that is how the book ended up in my hands. Generally I don't like libertarian solutions to current problems, but I found this book far less ideologic than others my husband has shared with me.
The book has piqued my interest, and I will no doubt read more on this topic in the future. Personally, I would love to find a book on this topic that also takes the environmental costs (see for example, "Plan B 2.0" by Lester Brown) of "premium medicine" into consideration when discussing the cost-benefit equations. Now that would be challenging and controversial!
Short, Well-Written, and Well-Reasoned.......2007-03-27
"Crisis of Abundance" should be read by any educated person who wants to understand the healthcare crisis in the U.S. and proposals to remedy it. This short, intelligent book reviews the various theories in play to explain why the U.S. spends so much more (as a percentage of GDP) on healthcare than other developed nations; looks at the "awkward facts" facing each theory; describes the trade-offs that any system for healthcare spending cannot avoid; and presents realistic policy considerations for improvement.
Even if you normally don't read "public policy" books, you should make time for this one. It will give you a solid foundation for evaluating what politicians and pundits say about the healthcare crisis and all the different fixes, both good and bad, that will be offered for your support.
A solid argument stating that not everybody requires extensive health care.......2006-06-03
Crisis Of Abundance: Rethinking How We Pay For Health Care by professional economist Arnold Kling is an in-depth and informative study of the American health care system and the troubling attributes which, when analyzed, require change if a worsening national crisis in health care is to be avoided. Offering a series of observational-based descriptive analysis as to current health care system stresses, Crisis Of Abundance presents a solid argument stating that not everybody requires extensive health care. Crisis Of Abundance is to be given high praise and very strongly recommended for its iconoclastic yet informative presentation of critically important issues surrounding the present and deepening crisis in American health care, as well as the cultural and political issues affecting attempts at reform.
Books:
- Talking from 9 to 5: Women and Men at Work
- The 48 Laws of Power
- The Basic Writings of John Stuart Mill: On Liberty, the Subjection of Women and Utilitarianism (Modern Library Classics)
- The Ecology of Commerce
- The Elusive Quest for Growth: Economists' Adventures and Misadventures in the Tropics
- The Elusive Quest for Growth: Economists' Adventures and Misadventures in the Tropics
- The Essays of Warren Buffett : Lessons for Corporate America
- The Great Risk Shift: The Assault on American Jobs, Families, Health Care, and Retirement--And How You Can Fight Back
- The Great Turning: From Empire to Earth Community (BK Currents)
- The Inmates Are Running the Asylum: Why High Tech Products Drive Us Crazy and How to Restore the Sanity
Books Index
Books Home
Recommended Books
- Mayflower: A Story of Courage, Community, and War
- Arthur Spiderwick's Field Guide to the Fantastical World Around You
- Occupational Health and Safety in the Care and Use of Nonhuman Primates: Nonhuman Primates
- Regulatory Mechanisms of Intracellular Membrane Transport
- The Mystery Method: How to Get Beautiful Women Into Bed
- Black Rose: In the Garden Trilogy
- Trevanian: 4 Complete Novels
- Old Penn Station
- The Finest Houses Of Paris
- The heather in lore, lyric and lay,: By Alexander Wallace
General
| Business & Investing
| Subjects
| Books
Essentials of Health Care Marketing
Financial Management of Health Care Organizations: An Introduction to Fundamental Tools, Concepts, and Applications
Legal Aspects of Health Care Administration
Health Care Management: Organization Design and Behavior
Healthcare Finance: An Introduction to Accounting and Financial Management
