This revealing book tackles the daunting problem of increasing chronic illness in America, offering fresh ideas for the ways in which the challenge can be successfully managed. Remaking Chronic Care in the Age of Health Care Reform: Changes for Lower Cost, Higher Quality Treatment is nothing less than a blueprint for a new mode of chronic care. It depicts a current system in which there is little financial incentive to furnish coordinated services via appropriate primary care and few penalties for failure to deliver such care. Arguing that the current system is unsustainable, the book documents efforts that have been made to promote better coordination of care through patient-centered medical homes and accountable care organizations. Specifically, the book focuses on linking the ongoing innovations in health care practices with the supports for scaling up innovations found in the Patient Protection and Affordable Care Act. It shows how expanding and improving primary care as the vehicle for care coordination will reduce costs for those with conditions such as arthritis, diabetes, hypertension, or other longstanding disorders, but also makes it clear that incentives have to be realigned if such improved primary care is to become a reality. 400 up-to-date references A brief history of the development of patient-centered primary care Qualitative descriptions of what it means to have a chronic illness and how it can be managed in the community Comments from patients about appropriate and inappropriate professional behavior

This important new study explores how American health care evolved in the 1990s, as well as the changes in public support and policy. Birenbaum examines where the interests of consumers and professionals have dovetailed and where they differ. He considers the health care systeM's future and suggested ways the system must be adjusted to provide better and wider coverage at reasonable costs. This volume is essential reading for scholars, students, and professionals in the medical field, as well as general readers concerned with health care issues.

The 90s saw the country moving toward a realization that health care had become unaffordable--or an enormous financial burden for people with otherwise adequate incomes. Health care providers and consumers alike worried that the problem was becoming uncontrollable. Doctors saw their autonomy and control eroded, employers saw their costs rising significantly, the costs began shifting to employees, and alternative approaches to cost containment were explored.

This revised edition of Arnold Birenbaum's important book brings the work up to date through the end of 1994 and the close of the 103rd Congress. It offers a comprehensive, provocative, and completely new assessment of health care reform with a focus on financing and coverage. A fine primer...on the health care debate (JAMA), the book examines such topics as the changing doctor-patient relationship, the growth of managed care, the rise and decline of hospitals, American business and health benefits, and the uninsured in America. This new edition takes particular heed to the failure of health care reform in 1994. In responding to the first edition, Victor Sidel, M.D., former president of the American Public Health Association, called it, "A wonderfully far-ranging, meticulously documented, insightfully analyzed and remarkably well written challenge to professionals, patients, and community members to work for effective change in a bizarre, expensive, inefficient, and often unresponsive medical care system."

Since the passage in 1990 of the Americans with Disabilities Act, society has made considerable strides in improving the quality of life and the productivity of individuals with disabilities. At the same time, however, the American health care system has undergone considerable change, with some unforeseen consequences for those with disabilities.

Birenbaum analyzes all of the disability and health policy issues that have emerged from our reliance upon managed care. First, he examines how disability has been defined and redefined in social science and in government regulations. Then, he discusses the major changes in health care over the last decade--in particular, the financial and organizational principles behind managed care. After reviewing the structural advantages and disadvantages of managed care for people with disabilities, he concludes with observations on the future of health care for people with disabilities, particularly in the context of the quality of life and the possible functional outcomes following medical interventions.

This book focuses on how a distinctly American product-managed care-got its start, how it works, and what needs to be adjusted in the future. As Birenbaum makes clear, this book is about social change. It is about doctors contracting with health maintenance organizations (HMOs) and being subject to their rules; about the limited access to specialty care; and about the frugal use of hospital admissions and stays. Consumers and providers have had mixed experiences in these health-delivery systems. Birenbaum, a health-policy analyst, has created a synthesis of research studies and analyses of trends to chronicle these developments and to suggest remedies to correct the most unjust aspects of managed care.

This book is about social change. It is about doctors contracting with HMOs and being subject to their rules; about the limited access to specialty care; and about the frugal use of hospital admissions and stays. Consumers and providers have had mixed experiences with HMOs. Birenbaum, a health-policy analyst, has created a synthesis of research studies and analyses of trends to chronicle these developments and to suggest remedies to correct the most unjust aspects of managed care. This is important reading for anyone concerned with contemporary health care in America.

This book examines the ongoing struggle for social justice by and for African Americans. Examining the persistent rolling back of civil and voting rights for this population and other minorities since the end of Reconstruction, the author discusses the continued colonization of African Americans and the rise of white nationalism before considering what can be done to create a democratic version of Americanism. With discussions on the possibilities that exist for eliminating health disparities, increasing income and reducing wealth inequality, enhancing the urban environment and housing stability, reforming criminal justice, and reconsidering the case for reparations for the descendants of slaves, the author considers whether white nationalism is a threat to Democratic Americanism and if the declining fortunes of working class Americans can be reversed by means of a "Marshall Plan" for the United States. A study of the sustained racial injustices of American society over the last century and a half and their possible remedies, A Nation Apart will appeal to all those with interests in race and ethnicity and questions of social justice.

This book examines the ongoing struggle for social justice by and for African Americans. Examining the persistent rolling back of civil and voting rights for this population and other minorities since the end of Reconstruction, the author discusses the continued colonization of African Americans and the rise of white nationalism before considering what can be done to create a democratic version of Americanism. With discussions on the possibilities that exist for eliminating health disparities, increasing income and reducing wealth inequality, enhancing the urban environment and housing stability, reforming criminal justice, and reconsidering the case for reparations for the descendants of slaves, the author considers whether white nationalism is a threat to Democratic Americanism and if the declining fortunes of working class Americans can be reversed by means of a "Marshall Plan" for the United States. A study of the sustained racial injustices of American society over the last century and a half and their possible remedies, A Nation Apart will appeal to all those with interests in race and ethnicity and questions of social justice.

This revised edition of Arnold BirenbauM's important book brings the work up to date through the end of 1994 and the close of the 103rd Congress. It offers a comprehensive, provocative, and completely new assessment of health care reform with a focus on financing and coverage. A fine primer...on the health care debate (JAMA), the book examines such topics as the changing doctor-patient relationship, the growth of managed care, the rise and decline of hospitals, American business and health benefits, and the uninsured in America. This new edition takes particular heed to the failure of health care reform in 1994.

In responding to the first edition, Victor Sidel, M.D., former president of the American Public Health Association, called it, "A wonderfully far-ranging, meticulously documented, insightfully analyzed and remarkably well written challenge to professionals, patients, and community members to work for effective change in a bizarre, expensive, inefficient, and often unresponsive medical care system."