Health Care in the United States Organization, Management, and Policy

A one-stop resource covering American health care and the challenges it faces 

In the newly revised Second Edition of Health Care in the United States: Organization, Management, and Policy, distinguished health and organizational researcher Dr. Howard P. Greenwald delivers a comprehensive exploration of the US health care system and the challenges its practitioners, professionals, and consumers face. 

From organization to management, financing, and evaluation, this book discusses the critical concepts, trends, and features of this sprawling set of interlocking systems. It also examines the historical origins of modern health care and how it delivers services to over 300 million Americans. Readers will discover: 

• Modern controversies in American health care that animate political debate and discussion, including the Affordable Care Act. 
• Discussions of the health care labor force, as well as its history, background, and crucial challenges. 
• Possible future directions for US health care, including preventive medicine, new policy initiatives, and proposals for reform. 

Written for students and professionals working in or studying health care management, health policy, public health, medical sociology, or anthropology, social work, or political science, this latest edition of Health Care in the United States is also a fascinating read for members of the general public curious about one of the most important services they'll ever interact with. 

Howard P. Greenwald is professor of management and policy at the University of Southern California School of Policy, Planning, and Development and clinical professor at the University of Washington School of Public Health. He is a specialist in program evaluation, organizational performance, health services research, and chronic disease epidemiology. He holds a PhD in sociology from the University of California at Berkeley. He has served as a faculty member at the University of Chicago Graduate School of Business, research scientist at Battelle Memorial Institute, chairman of the Network for Healthcare Management, director of the Health Services Administration Program at the University of Southern California, and commissioner on the Accrediting Commission for Education in Health Services Administration. He has recieved successive awards from Fulbright Canada to study the Canadian health care system. His current research focuses on innovation and change in formal organizations, socioeconomic effects on long term cancer survival, and evaluation of multisite interventions to improve the quality of life in disadvantaged communities. 

Tables and Figures 
Preface to Second Edition 
The Author 
Acknowledgements 


Part One: The System and Its Tasks 

1- Understanding Health Care 

Health Care as a National Concern 
Health Care Objectives and Goals 
Essential Challenges in Health Care 
Public Trust and Professional Ethics 
Three Perspectives on Management and Policy 

2- The U.S Health Care System: Features, Development, and Controversies 

The U.S Health Care System's Magnitude 
Uniqueness of the System 
The Impact of American Values 
Controversies in U.S. Health Care 

3- Major Health Problems in Modern Society 

Conceptions of Health and Disease 
The Causes of Disease 
Epidemiology: The Science of the Denominator 
Health, Illness, and Demand for Services 
Future Threats to Human Health 

4- Human Behavior, Health, and Health Care 

The Behavioral Dimension
The Concept of the Sick Role 
Health Risk Behavior 
Use of Health Services 
Adverse Patient Behavior 
Health Literacy and Cultural Competence 
Complementary and Alternative Medicine 
Consumer Preferences and Health Care Marketing 


Part Two: Means of Delivery

5- Health Care Organizations 

The Importance of Organization in Health Care 
Health Service Industry Sectors 
Ambulatory Care Organizations 
The Hospital 
The Managed Care Organization 
Other Health Care Organization 
Organizational Management in Health Care 

6- The Health Care Labor Force 

Health Care Labor Force Issues 
The Concept of Professionalism 
History, Background, and Challenges in Three Key Fields 
Clinicans as Managers 
The Health Care Labor Force: Facts and Figures 
Labor Force Dynamics in the Health Professions 
Professional Oversight and Discipline 

7- Health Care Expenditures, Financing, and Insurance 

Funding Sources and Expenditures 
Health Care Costs: A Global Issue 
Cost Accelerators in the United States 
The Health Insurance Landscape 
Additional Insurance Concepts and Terminology 
Medicare Specifics and Issues 
Affordable Care Act Coverage Expansion 
Uninsurance: The Continuing Problem 
Continuing Issues 

8- Biomedical Research and Program Evaluation 

The Importance of Research 
Principles of Experimental Design 
Modern Research Designs 
Outcome Measures 
Program Evaluation 
Cost-Effectiveness and Cost-Benefit Analysis 
The Social and Economic Context of Research 
Science Gone Wrong: Error, Distortion, and Fraud 


Part Three: Paths Forward 

9- Innovations and Outcomes 

Importance and Background 
Innovation Assessment: Measurement and Methods 
Selective Contracting 
Cost Sharing 
Managed Care 
Diagnosis Related Groups 
The Affordable Care Act 
Other Innovations 
Total Effects and Unanticipated Consequences 

10- Disease Prevention and Health Promotion 

The Importance of Prevention 
Preventable Morbidity and Mortality 
Prevention Dimensions 
Prevention in Practice 
Evidence-Based Prevention 
Health Promotion 
Challenges to Prevention 
Does Prevention Save Money? 
The Future: Prevention and U.S. Health Care 

11- Government, Policy, and Politics In Health Care 

Government and Health Care in the U.S. 
The Need for Government Participation 
How Government Shapes Health Care 
Politics: The Driver of Policy 
Political Money 
Effective Health Care Politics: Case Studies in Legislation 
The Case Against Government in Health Care 

12- Opportunities for Change 

Challenges to Reform 
Non-U.S. Health Care Systems 
Canada as a Model? 
Options for Furture Reform 


Glossary 
References