Americans have benefited from substantial improvements in health since the end of World War II. They live longer and grow taller; they have the safest and cheapest food supply on the planet; they have seen virtually all childhood diseases brought under control. Yet concerns about health remain widespread today. Cancer seems to be everywhere; autoimmune, nervous, and environmental diseases have reached pandemic proportions; medical malpractice suits have proliferated.

How can we have received so many benefits while still being as worried as ever about our health and the health care system established to ensure and extend those benefits? The historical perspective provided by the essays in this volume helps answer this question by identifying two points of significant change in health care policy. Beginning in the 1950s there emerged a subtle yet critical reconceptualization as the individual rather than the group came to figure prominently as the central policy-making unit. Then in the late 1960s a palpable sense of limits rendered the individualism of the previous decade into a Malthusian formulation: the greater the access or benefits that any one person received, the less others could get. Besides tracing these patterns in health care development, the essays also show how traditional notions of expertise have been affected by the changes. Contributors are Amy Sue Bix, Hamilton Cravens, Gerald N. Grob, Alan I Marcus, Diane Paul, David Rosner and Gerald Markowitz, and James Harvey Young.

This book presents a comparative analysis of mental health policy in Western Europe and North America. It also considers how and why different policies have developed.

Simon Goodwin examines the transition from institutional to community-based models of care for people with mental health problems, identifying variations in the inception, pace and style in which community-based service provision has emerged in different countries. Goodwin also assesses the problems and issues that have arisen as a result of the shift towards more community-based systems of care and treatment, and argues that it is a policy made up of conflicting aims and purposes, which is reflected in its implementation.

New ideas on the role of the state in developing countries have considerable implications for the social sectors, especially health. Certain international organizations have advocated a larger role for private sector health care providers and many developing country governments have adopted this approach. Yet, until now, very little evidence has existed about how shifting the balance between public and private roles might affect equity, and the quality and efficiency of health care. This book presents the results from a coordinated programme of research on the private health care sector including studies carried out by Asian, African and Latin American researchers. The conceptual chapters draw upon both industrialized and developing country literature to describe the intellectual terrain, analyse the key issues and summarize experience to date. This book will help increase understanding of the private sector, as well as illustrating the contentious issues involved in privatization. It will be useful to students and academics involved in international public health courses, and to health policy makers in developing countries.

Can the United States provide a health care program that offers a comprehensive package of the highest-quality health benefits to all Americans while containing health care costs? In this important book, Dr. William L. Kissick says that it cannot: no society in the world has sufficient resources to provide all the health services its population is capable of utilizing. Dr. Kissick was an active participant in the drafting of Medicare legislation in the 1960s and for the past twenty-five years has held joint positions in a medical school and a business school where he has specialized in health care management. Drawing on his long experience in the field, he discusses the dimensions of the current crisis, the financial and medical implications of alternative proposals--including the program put forth by the Clinton administration--and the requirements for long-term strategies. He argues that although there are no ideal solutions to health care reform, there are many significant programs at the regional, state, and local level that can serve as prototypes for the restructuring of the organization, financing, and delivery of health services. Dr. Kissick discusses some of these alternatives and suggests that after the federal government legislates a health care policy, it should be implemented through collaboration with state and local initiatives, for such programs have been built on an understanding of regional needs, expectations, and cultural diversity.

Experts agree--the U.S. has achieved the most technologically advanced medical care system in the world and it provides the highest quality, most comprehensive medical education available. Can we conclude that our health care system is one of America's success stories? It appears--we cannot. However, amid growing concern over our health care system, there is far less agreement on what to do about it. Jennie Kronenfeld addresses major health care controversies confronting American society, health care professionals, and policymakers. This intriguing book focuses on the overlapping area between policy sciences and health care studies, particularly the cost, access, and quality of health care. Kronenfeld discusses whether our system can solve its problems, or whether we have a health care "system" at all. Do we have a national health care "policy," or a web of state, county, and city policies? And, what of fundamental changes being adopted in the midst of the controversies surrounding reproductive health and abortion, mental health and behavioral health, disease patterns/physical health/AIDS, aging and long-term care, as well as the professions and facilities who provide care? A provocative examination of these important issues, Controversial Issues in Health Care Policy is essential reading for students of policy studies, health services, and sociology, as well as for policymakers, and health care professionals.

The second revised edition of a popular training guide designed to help health workers, including nurses, midwives, and medical assistants, improve their managerial skills. Acknowledging the close link between good management and good health care, the manual shows how a wide range of simple managerial tools can be used to stretch scarce resources, whether through more efficient use of time or less wastage of drugs. Throughout the book, numerous exercises, practical examples, case studies, cartoons, charts, and sample forms are used to help readers adopt a problem-solving attitude and relate advice and suggestions to their own daily problems. The guide features 14 chapters presented in four main parts, any one of which can be studied separately or as part of the whole, according to individual learning needs. The first part explains the general principles and functions of management. Part two, on personal relations, offers advice on how to motivate a health team, delegate authority, supervise, conduct meetings, and encourage high standards of work. The third and most extensive part describes problem-solving methods for the management of common problems involving equipment, drug supply, money, time, and space. The final part shows how the principles of good management can be applied to health care in a community.

Using the authors many years of experience in emergency services and his skills as a hazardous materials consultant, prepares the first responder to handle everything from re-establishing control and on-scene triage to investigating the crime. Including information on pre-incident and avoidance tactics, the author also discusses monitoring and detection techniques, protective equipment and decontamination, and an extensive list of resource organizations and training opportunities. This up-to-date 3rd edition is written to provide concise information for emergency responders who might be called upon to confront explosive, chemical, nuclear, biological, or incendiary acts of terrorism.

Radioactive sources such as nuclear power installations can pose a great threat to both humans and our environment. How do we measure, model and regulate such threats? Environmental Radioactivity and Emergency Preparedness addresses these topical questions and aims to plug the gap in the lack of comprehensive literature in this field. The book explores how to deal with the threats posed by different radiological sources, including those that are lost or hidden, and the issues posed by the use of such sources. It presents measurement methods and approaches to model and quantify the extent of threat, and also presents strategies for emergency preparedness, such as strategies for first-responders and radiological triage in case an accident should happen. Containing the latest recommendations and procedures from bodies such as the IAEA, this book is an essential reference for both students and academicians studying radiation safety, as well as for radiation protection experts in public bodies or in the industry.

While professional courses and how-to manuals can prepare us for expected events that will occur in the course of our careers, there remains an untapped reservoir of life experience that cannot be prepared for in training or study. These events and experiences give texture and meaning to our work and shape our character. Filled with stories of courage and inspiration, What They Didn't Teach at the Academy: Topics, Stories, and Reality Beyond the Classroom looks at experiences encountered by public safety and military professionals that were not necessarily encompassed in their training or realistically portrayed in simulations. Topics raised in the stories include: A doctor confronting her own debilitating and potentially fatal disease Cultural awareness and safe travel Suicide among law enforcement officers Departmental harassment of a new police recruit Coping with an addicted spouse Posttraumatic stress disorder Life as a K-9 handler The effect of work obligations on marriage and family Conflicts between moral beliefs and professional principles Debunking myths about Islam The book also examines coping mechanisms for stress and discusses the importance of observation, perception, and communication in facing challenging encounters. Through this collection of vignettes and philosophies, the contributors demonstrate that the lessons of life are not taught in colleges, universities, and academies but through hard experience.

"Cop Doc's Guide to Public Safety Complex Trauma Syndrome" is written in response to the need for an advanced, specialized guide for clinicians to operationally define, understand, and responsibly treat complex post-traumatic stress and grief syndromes in the context of the unique varieties of police personality styles. The book continues where Rudofossi's first book, "Working with Traumatized Police Officer Patients", left off. Theory is wed to practice and practice to effective interventions with police officer-patients. The 'how' and 'why' of a clinician's approach is made highly effective by understanding the distinct personality styles of officer-patients. Rudofossi's theoretical approach segues into difficult examples that highlight each officer-patient's eco-ethological field experience of loss in trauma, with a focus on enhancing resilience and motivation to - otherwise left disenfranchised. Thus, this original work expands the ecological-ethological existential analysis of complex PTSD into the context of personality styles, with an emphasis on resilience - without ignoring the pathological aspects of loss that often envelop officer-patient trauma syndromes.

`The author presents a plethora of infomation on users as individuals, their communities, research, healthcare markets and health service myths - old and new. It's a cool academic appraisal of where the power lies and how more might be shared with the patient' - Health Service Journal `Anything that helps us to understand the complexities of healthcare provision and what issues are important to users is therefore helpful. I welcome Christine Hogg's excellent summary of the issues raised by users about healthcare services. It clearly informs readers of the debates that need to take place and of the issues that healthcare practitioners should address in order to better serve their users.... So read the book to gain a better understanding of some of the issues that users feel strongly about' - British Medical Journal Making an original contribution to debates on health policy, this accessible and engaging book critically examines the future of health care and public health policy from the perspective of users and citizens. Consumerism, partnerships with patients and user involvement are seen as key to future health care and healthy public policies. The book outlines how individuals as patients, healthy people and research subjects relate to health services and how the public, as citizens, influence health care and public policies at local, national and international levels.

"Chronic Condition" provides a compelling analysis of the causes of the current health care crisis and of the shortcomings of reform proposals. It also offers an ingenious new framework for reform that, while minimizing government interference, would provide a means for financing care for the less affluent.

Sherry Glied shows that rising health care spending is consistent with a rising standard of living. Since we can, as a nation, afford more health care, reform must address not the overall level of health care costs but the distribution of health care spending.

Prior reform proposals, Glied argues, have failed to account for the tension between the clearly manifested desire for improving the quality of health care and the equally widespread interest in assuring that the less fortunate share in these improvements. After careful analysis of the ill-fated Clinton plan, Glied proposes a new solution that would make the willingness to pay for innovation the means of financing health care improvements for the less affluent. While rejecting the idea that the distribution of health care should be perfectly equal, Glied's proposal would enable all Americans to benefit from the dynamics of the free market.

From 1971 to 1982, researchers at the RAND Corporation devised an experiment to address two key questions in health care financing: how much more medical care will people use if it is provided free of charge? and what are the consequences for their health? This book presents a comprehensive account of the experiment and its findings. It will be an invaluable teaching tool and reference for anyone concerned with health-care policy.

One of the major concerns about the changing U.S. health-care systems is whether they will improve or diminish the quality and cost-effectiveness of medical care. The shift from a fee-for-service to a prepaid method of reimbursement has greatly changed the incentives of patients to seek care as well as those of providers to supply it. This change poses a particular challenge for care of depressed patients, a vulnerable population that often does not advocate for its own care. This book documents the inefficiencies of our national systems--prepaid as well as fee-for-service--for treating depression and explores how they can be improved.

Although depression is a major illness affecting millions of people, it is seriously undertreated in the United States. The ongoing shift of mental-health care away from specialists and toward primary medical-care providers is causing fewer depressed patients to be appropriately diagnosed and treated. Depression is frequently more devastating than other major illnesses, such as arthritis and heart disease, because it often begins at a younger age, when people are at their productive peak and thus at risk of permanently damaging their careers. It also differs from many medical conditions in that its indirect costs are usually much higher than direct treatment costs.

The authors urge the integration of both medical and economic considerations in designing policies for the treatment of depression. They show that by spending more money efficiently on care, the nation will gain greater health improvements per dollar invested and a more productive population.

Runaway medical costs, long-term care, market competition, for-profit medicine, nursing shortages-these are but a few of the issues that swirl around in the late twentieth century's volatile health care scene. How much of the system do we want to change, and how much do we want to keep? Health policy expert Eli Ginzberg examines such crucial questions in his characteristically broad-gauged perspective. Framing the issues in their historical, political, and professional contexts, the author analyzes how we have arrived at the current crisis. The book focuses on the three sides of the medical triangle that have separate and sometimes conflicting goals: the physicians want to provide the most health care for the most money; the government, which furnishes 40 percent of the system's funding, wants to limit the money it pays out for health care; and the public, with over a billion annual visits to doctors, wants the most health care for the least money. Ginzberg explains how the core components of our health care system-the community hospital and physicians who have long practiced in a fee-for-service mode-are under attack, and he indicates the factors that make it uncertain whether the destabilization will slow down or accelerate. Moreover, can key health care centers maintain their leadership in a time when new dollars for health are scarce? How will the floundering state of foundations affect medical care in local communities? In his final chapters the author zeroes in on the special concerns of the public: high-need patients (including those suffering from cancer, catastrophic illness, and the infirmities of old age, or those who are mentally ill or chronically poor), nursing shortages, unsuccessful cost containment, and lack of consensus within the medical triangle about the major issues on our nation's health agenda.

Published in Cooperation with the Midwest Council for Social Research on Aging Improved standards of living coupled with advancements in medical technology have enhanced much of the populations' opportunities for living long and productive lives. But what are the implications for living longer? Is living longer necessarily the best thing for the individual? And, what about the quality of that life? In this insightful volume, leading figures in social gerontology present state-of-the-art research on health and longevity. They discuss such consequential topics as health promotion and disease prevention, supply and demand for social and medical services, governmental and community response to needs, and effects of gender and ethnicity on health and life circumstances. In addition, they provide a sound basis for understanding the theoretical questions and empirical findings of a growing and multifaceted field. The Legacy of Longevity is an excellent resource for anyone wishing to understand the health and social implications of an aging population. Administrators and policymakers will find its practical information useful in planning and implementing programs to improve the health and social well-being of older persons. "Address[es] a variety of topics pertinent to the health care of older adults including conceptualizing and measuring health; social factors associated with becoming sick; use of health-care services; organization and financing of health-care services; and the interaction of the system with the individual. . . . Recommended for upper-level undergraduate and graduate students." --Choice "This book provides intelligent discussion of the important issues in health care and health policy for elderly people today. The authors' expertise in setting out their arguments clearly is obvious and the outcome is an inspired presentation of what could appear to be a dull topic. It should become a key text for the specialist readers." --Journal of Advanced Nursing "Purely as a work of reference, the book is very useful. But it is more than that. . . . There is no shortage of fresh insights or of controversial positions; the authors on the whole, do not get bogged down in the minutiae of their findings or the findings of others but set them in context and discuss them with concern and enthusiasm. . . . The editor is to be congratulated on the way in which he has assembled and balanced the various contributions, successfully weathering the perils of overlap and repetition." --Ageing in Society "The Legacy of Longevity is a multiauthor collaborative effort, full of information bound to be of interest to serious students, educators, and practitioners in the fields of aging. It provides a comprehensive overview of state-of-the-art research on health and longevity as these relate to social issues." --Pride Institute of Long Term Home Health Care

First responders in the fire, emergency, and police agencies work in high-risk, critical situations, and require effective leadership. Using the approach of Servant Leadership, Dr. Russell explains how executive level/chief officers can lead their teams by helping responders develop and perform as highly as possible and meet the needs of their followers. To bring the power of this philosophical approach towards leadership to life, this book demonstrates how its many aspects come together as a system, in order to strengthen the community of emergency responders. Featuring case studies and questions as meditative exercises, the book offers readers a rich learning experience. Targeted at fire chiefs, fire commissioners, police chiefs, and Emergency Medical Service, and other first responders, this book will have a positive impact on these organizations and the communities they serve. It is also useful for training aspiring executive level leaders/chief officers.

Natural and man-made disasters occur across the world, often without warning. Careful forward planning and preparedness to deal with emergencies can significantly reduce numbers of deaths, levels of disease, and general disruption to community life. Any programme of disaster prevention and preparedness should promote optimum co-ordination between the various governmental, non-governmental and private organizations involved. This manual is aimed at local managers ad decision-makers in the various sectors, including health, that need to co-operate in the process.

Presents the best of what the Net has to offer in healthcare management and medicine. Designed to save computer users' time, money and frustration, this resource summarizes the most creative and practical sites on the Net and provides an up-to-date listing of how to find them. The work includes the online address and a brief summary of each site, along with highlights of notable downloads and forums. It also features a rating system for evaluating each site, including response time, content, graphics, interactivity and overall value.

The opportunity to fill empty beds, increase utilization, and bolster revenues without adding staff has made subacute care one of the fastest growing subspecialties in healthcare. Hospitals, nursing facilities, and independent management companies have discovered that subacute care - the area of patient care that lies somewhere between inpatient hospitalization and long-term care services - is capable of generating more profits for financially healthy institutions or turning around struggling organizations. Subacute Care Services introduces and defines this financially prosperous industry while addressing the intrinsic value of its services to healthcare professionals. Subacute Care Services provides a pragmatic look at the development process for starting a subacute care unit and discusses the hospital versus long-term care facility as a unit site. Written by the leading experts in the field, Subacute Care Services is a "must" read for healthcare professionals in hospitals and long-term care.