Reviewer: Eugene C. Rich, MD (Creighton University Medical Center)
Description: The book begins with a superb introduction to some of the critical issues facing the U.S. healthcare system in 1996. The work then provides a series of chapters on various topics relevant to the evolution of healthcare financing and delivery in the U.S. These are written by leading authorities in the field and cover such matters as healthcare costs, the changing organization of the delivery system, the role of quality management, legal issues relevant to competition, and developments affecting special populations.
Purpose: The purpose of this work is to review the recent changes in the U.S. healthcare system and to consider the implications.
Audience: The principle audience for this work is decision makers at the community level, i.e., healthcare executives and administrators. This book would also be an excellent resource for educators and students of issues in current U.S. health policy.
Features: In addition to the excellent introduction, the book provides thoughtful, authoritative, and thoroughly referenced discussions on many critical issues. Particularly praiseworthy is the chapter on the organization of health care delivery by Shortell, the section on rationing health care by Reinhardt, and the discussion of physician workforce by Kindig. The quality of the scholarship in this book is generally quite high. The chapters are well written and well organized with many helpful tables and illustrations.
Assessment: In this decade of rapid change in our system of organizing and financing healthcare, there are many books that attempt to develop a meaningful synthesis. This is one of the few works that delivers on its promise. The authors generally provide scholarly, authoritative, discussions drawing upon their wealth of expertise. The commentaries are consistently well informed and often present provocative insights.
