In recent decades, American medicine has become increasingly politicized and politics has become increasingly medicalized. Behaviors previously seen as virtuous or wicked, wise or unwise are now dealt with as healthy or sick--unwanted behaviors to be controlled as if they were health issues. The modern penchant for transforming human problems into diseases and judicial sanctions into treatments, replacing the rule of law with the rule of medical discretion, leads to the creation of a type of government social critic Thomas Szasz calls pharmacracy.

Medicalizing troublesome behaviors and social problems is tempting to voters and politicians alike: it panders to the people by promising to satisfy their needs for dependence on medical authority and offers easy self-aggrandizement to politicians as the dispensers of more and better health care. Thus, the people gain a convenient scapegoat, enabling them to avoid personal responsibility for their behavior. The government gains a rationale for endless and politically expedient wars against social problems defined as public health emergencies. The health care system gains prestige, funding, and bureaucratic power that only an alliance with the political system can provide.

However, Szasz warns, the creeping substitution of pharmacracy for democracy--private medical concerns increasingly perceived as requiring a political response--inexorably erodes personal freedom and dignity. "Pharmacracy: Medicine and Politics in America" is a clear and convincing presentation of this hidden danger, all too often ignored in our health care debates and avoided in our political contests.

Among the most critical issues facing society today is the provision of community support for people of all ages who require assistance in performing daily living tasks. Researchers have documented the support systems and needs of older persons, children with special health care needs, and young persons transitioning into adulthood. While the United States may not yet have solved many of the challenges of providing adequate supports to these populations, researchers at least have a good sense of the nature of those challenges and are working toward that end. Somewhat surprising, then, is the nearly complete lack of knowledge about the support systems and needs of a rapidly growing population of adults who are not yet considered old but who nevertheless need help due to traumatic injury, the congenital illnesses of childhood and young adulthood, and/or the early onset of chronic diseases typically associated with later life (e.g., arthritis, heart disease and cancer). Specifically, researchers know little about the millions of Americans who require assistance during the period of late middle age, a transition phase between middle age and the older years, when activity limitations associated with a chronic condition escalate sharply. The largest generation in American history to date--the baby boom generation--has begun to enter late middle age, the oldest of whom turned sixty in 2006. While the research community looks ahead to the likely strains this generation will place on the formal long-term care system, Medicare, and the Social Security system in the near future, those who find themselves in need of personal care in late middle age must first pass through a particularly vulnerabletime before they are eligible to benefit from the safety net these systems afford. Because late-middle-aged adults are often considered the "carers" of society (many caring for dependent children or aging parents, and often both), we do not often think of this group as vulnerable and in need of help themselves. They, more than others, are left to rely on their own financial and family support systems to get through their difficult time, while at the same time planning and preparing for the possibility of living another 20 years or more with chronic illnesses and conditions. Up until now, we have known very little about how, and how well, they manage. In this first critical study of the availability and receipt of care for late-middle-aged adults, Julie Lima and Susan Allen uncover a host of vulnerabilities that challenge the wellbeing of those who find themselves in need of personal assistance at a critical point in their lives. Using a lifecourse approach, they outline the care needs of older adults in various stages of life, as well as the sociodemographic and policy trends that influence the amounts and types of care that are available, and that will likely be available in the near future. Since so little was known about the care needs of this group prior to this work, this book is largely descriptive in nature, and the authors intend for it to lay the groundwork for future work in this area. This is an important book for all gerontology, disability, and lifecourse collections.

In 1977 the average American spent $755 per year on health care, most physicians functioned as independent practitioners, and only 5.6 million people under the age of 65 were enrolled in HMOs. Twenty years later, per capita expenditures had more than tripled, most physicians practiced within a managed care environment, and HMO enrollment stood at 62 million. Keeping pace with these and other changes in the U.S. health system has been the job of the National Medical Expenditure Surveys (NMES). Since they were first started in the 1970s, these federal government surveys have defined our basic understanding of how individuals and families use and pay for America's health care systems and have directly influenced national policy changes, health care reform, and cost-control strategies.

Informing American Health Care Policy is the definitive resource that analyzes the overall effect of the National Medical Expenditure Surveys. This important edited collection is written by an outstanding panel of experts from a variety of disciplines and includes contributions from nationally known economists, sociologists, and survey researchers. Rich in insights and lessons learned, Informing American Health Care Policy
Offers a critical assessment and a discerning overview of NMES' outcomes
Describes how the design strategies and methods evolved over the past two decades
Provides a detailed discussion about the collection of a wide range of data on health insurance and employment status
Addresses troublesome issues in defining and measuring access in vulnerable populations
Summarizes the multiple and complex issues of survey design, population sampling, and analytical method
Demonstrates the indispensability of NMES data in the health reform debates

The contributors examine how the current health care environment reflects the successes and failures of previous research and makes recommendations on how to adapt survey research to be more effective in the future.

The Important Lessons Learned from the National Medical Expenditure Surveys

Informing American Health Care Policy provides a critical perspective on the National Medical Expenditure Surveys (NMES) and how these surveys have responded to the sometimes conflicting challenges of policy and research. Sponsored by the Agency for Health Care Policy and Research and written by a stellar panel of interdisciplinary experts including contributions from nationally known economists, sociologists, and survey researchers, this essential resource is filled with lessons learned and emerging strategies for the future.

"I enjoyed reading this book. Thanks to the major investment in health expenditure and insurance surveys and the increasingly sophisticated analytic capacity described in this volume, policy officials now have a much more precise and up-to-date understanding of the implications of policy choices."--Karen Davis, president, The Commonwealth Fund; developed President Carter's 1977 national health reform proposal

"In this important book, the lead researchers associated with NMES describe the development of this rich data source and, in a series of well-crafted papers, illustrate the use of these data in informing major areas of health policy. It is a must read for anyone interested in American health policy-especially for younger professionals entering this growing field."--Uwe E.Reinhardt, James Madison Professor of Political Economy, Princeton University

"National health expenditure surveys have provided policymakers with the information they need to make informed decisions. This volume tells us about the evolution and contributions of the federal government's most ambitious health care survey. I recommend it for those interested in improving the quality of data available to those who formulate policy."--John K. Iglehart, founding editor, Health Affairs

"Thoughtful and informed reflections on the lessons learned by NMES. Provides sound guidance and procedures required to address the enduring policy questions of Who's covered? Who pays?, and How much? in the emerging U.S. health care environment of the future."--Lu Ann Aday, professor of behavioral sciences and management and policy sciences, the University of Texas School of Public Health; and author, Designing and Conducting Health Surveys, Fourth Edition

This unique book reveals how Collaborative Innovation Networks (COINs) can be used to achieve resilience to change and external shocks. COINs, which consist of 'cyberteams' of motivated individuals, are self-organizing emergent social systems for coping with external change. The book describes how COINs enable resilience in healthcare, e.g. through teams of patients, family members, doctors and researchers to support patients with chronic diseases, or by reducing infant mortality by forming groups of mothers, social workers, doctors, and policymakers. It also examines COINs within large corporations and how they build resilience by forming, spontaneously and without intervention on the part of the management, to creatively respond to new risks and external threats. The expert contributions also discuss how COINs can benefit startups, offering new self-organizing forms of leadership in which all stakeholders collaborate to develop new products.

This provocative appraisal unpacks commonly held beliefs about healthcare management and replaces them with practical strategies and realistic policy goals. Using Henry Mintzberg's "Myths of Healthcare" as a springboard, it reveals management practices that undermine care delivery, explores their cultural and corporate origins, and details how they may be reversed through changes in management strategy, organization, scale, and style. Tackling conventional wisdom about decision-making, cost-effectiveness, service quality, and equity, contributors fine-tune concepts of mission and vision by promoting collaboration, engagement, and common sense. The book's multidisciplinary panel of experts analyzes the most popular healthcare management "myths," among them: * The healthcare system is failing. * The healthcare system can be fixed through social engineering. * Healthcare institutions can be fixed by bringing in the heroic leader. * The healthcare system can be fixed by treating it more as a business. * Healthcare is rightly left to the private sector, for the sake of efficiency. The Myths of Health Care speaks to a large, diverse audience: scholars of all levels interested in the research in health policy and management, graduate and under-graduate students attending courses in leadership and management of public sector organization, and practitioners in the field of health care.

You Don't Have to Do It Alone

Whether you're prepared for it or not, chances are you'll take on the role of caregiver when a family member or friend is affected by a serious illness or injury, or when you find your elderly parent needs help. As you'll soon discover, the range of tasks and responsibilities involved are overwhelming. "Share The Care" offers a sensible and loving solution: a unique group approach that can turn a circle of ordinary people into a powerful caregiving team. "Share The Care" shows you how to:

• Create a caregiver "family" from friends, real family members, neighbors, coworkers, and acquaintances.
• Hold a meeting to organize your group, and introduce members to the Share The Care systems that guarantee every job will be done and no one person will have to do too much.
• Discover the hidden talents within the group, make the most of their resources, cope with group issues, and stay together in the face of adversity.

Included here are valuable guidelines, compassionate suggestions, and a simple-to-use workbook section that together offer support to free the patient from worry and the caregivers from burnout. "Share The Care" offers friends and family the best answer ever to the frequently asked question "What can I do?"

This book fosters a scientific debate for sophisticated approaches and cognitive technologies (such as deep learning, machine learning and advanced analytics) for enhanced healthcare services in light of the tremendous scope in the future of intelligent systems for healthcare. The authors discuss the proliferation of huge data sources (e.g. genomes, electronic health records (EHRs), mobile diagnostics, and wearable devices) and breakthroughs in artificial intelligence applications, which have unlocked the doors for diagnosing and treating multitudes of rare diseases. The contributors show how the widespread adoption of intelligent health based systems could help overcome challenges, such as shortages of staff and supplies, accessibility barriers, lack of awareness on certain health issues, identification of patient needs, and early detection and diagnosis of illnesses. This book is a small yet significant step towards exploring recent advances, disseminating state-of-the-art techniques and deploying novel technologies in intelligent healthcare services and applications. Describes the advances of computing methodologies for life and medical science data; Presents applications of artificial intelligence in healthcare along with case studies and datasets; Provides an ideal reference for medical imaging researchers, industry scientists and engineers, advanced undergraduate and graduate students, and clinicians.

This book examines the causes and consequences of suicide from the perspective of economics. The approach here differs from those in medical, psychiatric, epidemiological, and sociological studies of suicide and is thus novel in a way that highlights the importance of economic and institutional settings in the problem of suicide. The authors argue that suicide imposes a tremendous economic cost on contemporary society in a variety of ways, requiring the government to develop an effective prevention strategy. An empirical analysis using data from Japan and other developed countries shows that natural disasters and economic crises increase suicide rates, while liberal government policies favorable to the poor can decrease them. Further, the types of effective prevention strategies in the context of railway/subway suicides, celebrity suicides, public awareness campaigns, and education using data primarily from Japan are revealed. This book ultimately contributes to an understanding of suicides and the development of evidence-based policy proposals. The Japanese version of this book won the 56th Nikkei Prize for Economics Books (Nikkei Keizai Tosho Bunka Award) in 2013. Yasuyuki Sawada is Chief Economist of the Asian Development Bank and Professor of Economics at The University of Tokyo. Michiko Ueda is Associate Professor in the Faculty of Political Science and Economics at Waseda University. Tetsuya Matsubayashi is Associate Professor of Osaka School of International Public Policy (OSIPP) at Osaka University.

There is wide consensus that our current healthcare system is, to put it mildly, broken. In this time of HMOs, mismanaged care, and a failing Medicare system, patients and doctors alike are dissatisfied with the status quo. But Knope explains that there is a solution - Concierge Medicine. This new system, sweeping the nation yet still the subject of some controversy, allows consumers to contract directly with a doctor to get individualized care. It's a return to Marcus Welby-style medicine, says Knope, and it provides what he calls a critical element for the best care - time. Ample time for doctors to care for their patients, and to restore the doctor-patient relationship that has fallen into the past with our current assembly-line, fast food medicine. The first book published giving in-depth explanation of Concierge Medicine, this work also provides concrete advice on how to find, interview, and budget for a concierge doctor, using changes in tax law that allow patients to open Health Savings Accounts. Patient vignettes provide personal insights from consumers of Concierge Medicine, and further description of what is involved to use this new approach for optimal health.

Knope clearly explains the pressures that led to our current assembly-line healthcare system, allowing the reader to see also why the fact that a typical doctor's visit these days lasts just seven minutes works against any attempt to get, or for doctors to give, the best of care. Health is our most precious asset, says Knope, and like financial wealth, what he sees as health wealth also takes time, effort, and money to nurture. The three critical components of optimal health discussed are: a good relationship with a qualified doctor, regular exercise, and good nutrition. Concierge doctors customize a nutrition and exercise program unique to the needs of each individual. Yet there are detractors who argue Concierge Medicine is unfair, because it allows just those who can afford it unlimited access to a doctor. Knope confronts that question of medical ethics also. This book will doubtless stimulate not only ideas and action, but wide discussion and debate.

"This timely book provides insight into the changing role of the 'hospital' in the face of technological, organizational innovation and ever-tightening health budgets."James Barlow, Imperial College Business School, UK "This book covers various relevant aspects of the hospital in different states and contexts. Underlining the importance of business models for future hospitals, this publication presents models of care from a historic and a current perspective. All authors possess a deep insight into different health care systems, not only as scholars but as experts working for world-renowned health policy institutions such as the World Health Organization, the World Bank or the European Observatory for Health Systems."Siegfried Walch, Management Center Innsbruck, Austria "For an organisation like mine, representing those involved in the strategic planning of healthcare infrastructure, this book provides invaluable insights into what really matters - now and for the future - in the complex and contentious field of hospital development."Jonathan Erskine, European Health Property Network, Netherlands This book seeks to reframe current policy discussions on hospitals. Healthcare services turn expensive economic resources-people, capital, pharmaceuticals, energy, materials-into care and cure. Hospitals concentrate the use and the cost of these resources, particularly highly-trained people, expensive capital, and embedded technologies. But other areas of health, such as public health and primary care, seem to attract more attention and affection, at least within the health policy community. How to make sense of this paradox? Hospitals choose, or are assigned, to deliver certain parts of care packages. They are organised to do this via "business models". These necessarily incorporate models of care - the processes of dealing with patients. The activity needs to be governed, in the widest senses. Rational decisions need to be taken about both the care and the resources to be used. This book pulls these elements together, to stimulate a debate.

Advancing the Human Right to Health offers a prospective on the global response to one of the greatest moral, legal, and public health challenges of the 21st century - achieving the human right to health as enshrined in the Universal Declaration of Human Rights (UDHR) and other legal instruments. Featuring writings by global thought-leaders in the world of health human rights, the book brings clarity to many of the complex clinical, ethical, economic, legal, and socio-cultural questions raised by injury, disease, and deeper determinants of health, such as poverty. Much more than a primer on the right to health, this book features an examination of profound inequalities in health, which have resulted in millions of people condemned to unnecessary suffering and hastened deaths. In so doing, it provides a thoughtful account of the right to health's parameters, strategies on ways in which to achieve it, and discussion of why it is so essential in a 21st century context. Country-specific case studies provide context for analysing the right to health and assessing whether, and to what extent, this right has influenced critical decision-making that makes a difference in people's lives. Thematic chapters also look at the specific challenges involved in translating the right to health into action. Advancing the Human Right to Health highlights the urgency to build upon the progress made in securing the right to health for all, offering a timely reminder that all stakeholders must redouble their efforts to advance the human right to health.

This multifaceted book examines the free market reform of the Chinese healthcare system in the 1980s and the more collectivist or socialist counter-reforms that have been implemented since 2009 to remedy some of the problems introduced by marketization. The book is based on an ethnographical study in a Chinese county from 2011 to 2012, which investigated local people's experience of healthcare reforms and the various ways in which they have adapted their own behavior to the constraints and opportunities introduced by these reforms. It provides a vivid depiction of the morality and emotionality of people's experiences of the Chinese healthcare system and the myriad frustrations and sometimes desperation it induces not only among patients with significant health problems and their families, but also healthcare practitioners caught between their desire to do right by their patients and the penalties they personally incur if they do not adhere to institutionalized cost-saving measures. The people's experiences within China's health sector presented reflect many similar experiences in the wider Chinese society. The book is thus a valuable resource for researchers and graduate students interested in China's healthcare reforms and scholars concerned with issues of contemporary Chinese society.

This book critically analyses the influence of international policies and guidelines on the performance of interventions aimed at reducing health inequities in Latin America, with special emphasis on health promotion and health in all policies strategies. While the implementation of these interventions plays a key role in strengthening these countries' capacity to respond to current and future challenges, the urgency and pressures of cooperation and funding agencies to show results consistent with their own agendas not only hampers this goal, but also makes the territory invisible, hiding the real problems faced by most Latin American countries, diminishing the richness of local knowledge production, and hindering the development of relevant proposals that consider the territory's conditions and cultural identity. Departing from this general analysis, the authors search for answers to the following questions: Why, despite the importance of the theoretical advances r egarding actions to address social and health inequities, haven't Latin American countries been able to produce the expected results? Why do successful initiatives only take place within the framework of pilot projects? Why does the ideology of health promotion and health in all policies mainly permeate structures of the health sector, but not other sectors? Why are intersectoral actions conjunctural initiatives, which often fail to evolve into permanent practices? Based on an extensive literature review, case studies, personal experiences, and interviews with key informants in the region, Globalization and Health Inequities in Latin America presents a strategy that uses monitoring and evaluation practices for enhancing the capacity of Latin American and other low and middle-income countries to implement sustainable processes to foster inclusiveness, equity, social justice and human rights. <

For fifty years, Medicare and Medicaid have stood at the center of a contentious debate surrounding American government, citizenship, and health care entitlement. In Medicare and Medicaid at 50, leading scholars in politics, government, economics, health policy, and history offer a comprehensive assessment of the evolution of these programs and their impact on society - from their origins in the Great Society era to the current battles over the Affordable Care Act ("Obamacare"). These highly accessible essays examine Medicare and Medicaid from their origins as programs for the elderly and poor to their later role as a safety net for the middle class. Along the way, they have served as touchstones for heated debates about economics, social welfare, and the role of government. Medicare and Medicaid at 50 addresses key questions for understanding the past and future of health policy in America, including: DT What were the origins for these initiatives, and how were they transformed over time? DT What marks have Medicare and Medicaid left on society? DT In what ways have these programs produced innovation, even in eras of retrenchment? DT How did Medicaid, once regarded as a poor person's program, expand its benefits and coverage over the decades to become the platform for the ACA's future expansion? The volume's contributors go on to examine the powerful role of courts in these transformations, along with the shifting roles of Congress, public opinion, and state governors in the programs' ongoing evolution. From Lyndon Johnson to Barack Obama on the left, and from Ronald Reagan to George W. Bush on the right, American political leaders have tied their political fortunes to the fate of America's entitlement programs; Medicare and Medicaid at 50 helps explain why, and how those ongoing debates are likely to shape the future of the Affordable Care Act.

This book provides a general overview of intelligence in health policy, health-care organizations and health services in the light of the current EU digital agenda, which aims to make health data and e-health tools publicly available. The first part analyses the implications of knowledge management and decision-making procedures for intelligent health policies and governance. The second part discusses in detail the concept of intelligence and illustrates why the perspective of organizational intelligence offers a solution to contemporary problems in health care, while the third part focuses on intelligent leadership models in health-care organizations. Providing a guide to new ways of understanding, developing, and reforming health policy and health services, it appeals to scholars as well as decision-makers in health governance and health-care institutions.

E-health communities, also called Web-based health communities, have become popular arenas for support and sharing of experience, knowledge and advice among patients and citizens. E-health communities are used on a day-to-day basis by people who help each other cope with different health conditions and learn together about health-related issues and behaviors. E-Health Communities and Online Self-Help Groups: Applications and Usage will aim to provide relevant theoretical frameworks and the latest empirical research findings in the area. It aims to increase knowledge and understanding of applications and usage of e-health communities for self-help groups who struggle with health disorders, disabilities, lifestyle issues and other health concerns. Different e-health community settings will be presented, observations of community usage and effects discussed, and complementing ways to measure effectiveness will be introduced and analyzed.

Every year, the average American spends about $7,300 on medical expenses. The typical Canadian pays $2,700, the Briton only $2,000. And yet, according to the World Health Organization, our healthcare system, in terms of total quality, ranks thirty-eighth in the world, right between Costa Rica and Slovenia. Not only do 40 million Americans lack health insurance, but more than 200,000 die each year because of medical mistakes. Our average life expectancy is lower than Cuba's.
In Next Medicine, Dr. Walter Bortz zeroes in on why the American medicine is spiraling toward disaster. A physician with fifty years of experience and a leading authority on aging, Bortz argues that the financial interests of biotech and drug companies have distorted the healthcare system. Thanks to them, medicine today is economically motivated to treat disease rather than to prevent it. Heart disease, for example, is widely treated with drug interventions and invasive surgery--both of which are extravagantly profitable for pharmaceutical giants and hospitals. Daily exercise and a healthy diet, on the other hand, can prevent heart disease, and can be obtained by patients essentially for free--but there's no money in that. The medical-industrial complex has a vested interest in keeping us sick, and until that changes medicine will fail to effectively address the leading cause of disability and mortality today: chronic diseases like diabetes that are largely preventable. Bortz proposes a medical system that emphasizes personal responsibility and provides incentives for healthy lifestyle choices, along with new training for medical professionals.
Through a lively narrative full of personal anecdotes and jarring statistics, Bortz makes a powerful case for a radically new medical system--one that is based on rigorous science and loosens the strangle hold of corporate interests on American health.

Engage: Designed for the needs of the Entry 3/Level 1 learner with a full colour, spread-based approach, and topics broken into clear, bite-sized chunks to retain learners' attention. Lively activities, mini case studies and clear checklists and summaries help learners engage with - and remember - content. Achieve: Covering 11 units at Level 1 - enough for a Diploma, and 2 Units at Entry Level 3 - enough for an Award, so learners can be confident they have the content they need to achieve their qualification. Edexcel's own Assignment tips, written by BTEC experts, help learners to achieve their potential in assessments. Activities mapped to the assessment criteria in each unit, provide support and clear direction for learners, helping them to work towards the criteria. Progress: Prepares learners for employment with a focus on employability skills and definitions of key terms. Helps learners progress to BTEC Level 2 First by building their confidence with the style of BTEC qualifications.

This ambitious resource presents an inventive approach to integrating pediatric and mental health care based in comprehensive, family-centered service delivery. Its framework adds a problem-solving focus to the core principles of pediatric consultation-liaison psychiatry, emphasizing young patients' developmental, family, and social context. An international panel of expert clinicians explores the value of the mental health component in treating complex and chronic cases across varied settings, as well as practical considerations in implementing collaborative pediatric care systemwide, including at the global level. Detailed case histories illustrate skills and traits essential to making this problem-based approach work, such as multidimensional thinking, a prevention mentality, a dedication to lifelong learning, and empathy and respect for young clients and their families. Included in the coverage: * Pediatric medicine for the child psychiatrist. * Safety issues in a general medical facility setting. * "Other medical" presentations and considerations in pediatric consultation-liaison psychiatry. * Principles of biopsychosocial formulation and interventions in the pediatric medical setting. * Preventive models for reducing major causes of morbidity and mortality in childhood. Child and adolescent psychiatrists, child and school psychologists, and physicians in pediatrics, general practice, and family medicine will welcome Pediatric Consultation-Liaison Psychiatry as both a robust training text and a blueprint for the future of children's medicine.