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Tables of Contents for Introduction to U.S. Health Policy
Chapter/Section Title
Page #
Page Count
Foreword
xi
Preface
xii
Acknowledgments
xxi
Health, Health Care, and the Market Economy
1
15
The Unique History of Health Care in America
2
3
The Rising Cost of Health Care in America
5
3
The Growing Number of Uninsured Americans
8
1
The Health of Our Society: What Do We Get for Our Money?
9
3
What Determines the Overall Health of a Society?
12
4
Health Care in America as a Reflection of Underlying Cultural Values and Institutions
16
23
The Cultural Basis of Health Care Delivery: Comparing the United States and Canada
17
1
The Historical Development of the Canadian Health Care System
18
6
The Organizing Principles of the Canadian Health Care System
24
2
The Organizing Principles of the U.S. Health Care System
26
1
Cultural Institutions That Drive Health Care in the United States
27
9
How Differing Cultural Institutions Affect the Cost of Health Care
36
3
The Health Professions and the Organization of Care
39
28
Physicians and the American Medical Profession
40
6
Nursing in the United States
46
1
Primary Care and the Role of Primary Care Physicians
47
4
Nurse Practitioners and Other Advanced Practice Nurses
51
2
Secondary Care---Specialist Physicians
53
3
Foreign Medical Graduates and Their Effect on the Medical Profession
56
2
Future Policy Directions for Physician Supply and Specialty
58
2
Secondary Care---The Hospital
60
4
Tertiary Care, Quaternary Care, and the Academic Medical Center
64
3
Paying for Health Care: Health Insurance and the Birth of the HMO
67
22
Federal Policies that Boosted Employee Health Insurance
68
6
Insurance Plans, Service Plans, and Capitation
74
2
Kaiser-Permanente and the Development of Health Maintenance Organizations
76
4
The HMO Act of 1973 and the Expansion of HMOs
80
4
Other Types of Managed Care Plans
84
5
Medicare
89
19
Medicare: Universal Health Insurance for the Elderly
91
5
Medigap Insurance
96
2
The Extension of Medicare to the Disabled and to Those with Kidney Failure
98
1
The Rising Cost of Medicare
99
1
Changes in the Way Medicare Pays Physicians
100
2
Taking Care of the Few: The Skewed Nature of the Medicare Population
102
2
Strange Bedfellows: Medicare and Paying for Graduate Medical Education
104
1
Major Policy Questions Facing Medicare
105
3
Medicaid
108
18
Services Provided Under the Medicaid Program
110
1
Eligibility for Medicaid
111
3
The Rising Costs of the Medicaid Program
114
3
The Move to Managed Care
117
1
The Oregon Plan: Explicit Health Care Rationing
118
3
Tennessee: Managed Care for All Medicaid Beneficiaries---Overnight
121
1
California: Incremental Shift to Medicaid Managed Care
122
1
The Long-Term Outlook for Medicaid
123
1
Appendix 6.1
124
2
The Managed Care Revolution
126
25
Managed Competition: An Idea Whose Time Had Come
128
5
Putting Managed Competition into Action: The Clinton Health Reform Proposal
133
2
The Shift to for-Profit, Managed Care: The Market Does What the Government Would Not
135
1
Concerns About the Effects of Managed Care and Managed Competition
136
15
Recent Changes to the Medicare Program
151
19
The Initial Move to Medicare HMOs: Getting More for Less for Medicare Beneficiaries
152
3
Problems in HMO Risk Contracting: Favorable Selection and the Average Cost of Care
155
3
The Balanced Budget Act of 1997 and its effect on Medicare
158
7
The Best-Laid Plans...: Unintended Consequences of the Balanced Budget Act
165
3
Why Did Medicare HMOs Have So Little Success in Holding Down Costs?
168
2
Long-Term Care
170
17
The Growing Need for Long-Term Care Among the Frail Elderly
171
1
Nursing Home Care
172
4
Home Health Care
176
4
Hospice Care
180
2
Life-Care Communities as an Alternative to Long-Term Care
182
1
Future Policy Issues in Long-Term Care
183
4
The Uninsured
187
17
The Creation and Expansion of Health Insurance in the Twentieth Century
188
2
The Issue of the Uninsured Finds the American Mainstream: Wofford Versus Thornburgh, 1991
190
1
Understanding the Uninsured: Who Are They, and Why Are They Uninsured?
191
4
The Source of the Uninsured: Low-Wage Workers and Small Employers
195
3
Two Programs to Reduce the Number of Uninsured
198
6
Factors Other Than Health Insurance That Impede Access to Care
204
19
Type of Health Insurance Coverage and Access to Care for Urgent Problems
205
2
The Effect of Out-of-Pocket Expenses on the Rate at Which Patients Access Care
207
1
The Effect of Medicaid Coverage on Patients' Access to Care
208
1
Racial Barriers to Health Care Access
209
6
Living Conditions and Care
215
1
Other Factors That May Affect Access to Care
216
1
The Increasing Organizational Complexity of Health Care as a Barrier to Care
216
7
Where Do We Go from Here?
223
16
Health Care Rationing: Is It Inevitable? Can It Be Acceptable?
227
5
Profit as a Competitor to Cost, Quality, and Access
232
2
Physician Heal Thyself: Physicians and the Profit Motive
234
5
Index
239