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An Introduction to the US Health Care Industry

Balancing Care, Cost, and Access

David S. Guzick, MD, PhD

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Why does US health care have such high costs and poor outcomes? Dr. David S. Guzick offers this critique of the American health care industry and argues that it could work more effectively by rebalancing care, cost, and access.

For decades, the United States has been faced with a puzzling problem: Despite spending much more money per capita on health care than any other developed nation, its population suffers from notoriously poorer health. In comparison with 10 other high-income nations, in fact, the US has the lowest life expectancy at birth, the highest rates of infant and neonatal…

Why does US health care have such high costs and poor outcomes? Dr. David S. Guzick offers this critique of the American health care industry and argues that it could work more effectively by rebalancing care, cost, and access.

For decades, the United States has been faced with a puzzling problem: Despite spending much more money per capita on health care than any other developed nation, its population suffers from notoriously poorer health. In comparison with 10 other high-income nations, in fact, the US has the lowest life expectancy at birth, the highest rates of infant and neonatal mortality, and the most inequitable access to physicians when adjusted for need.

In An Introduction to the US Health Care Industry, Dr. David S. Guzick takes an in-depth look at this troubling issue. Bringing to bear his unique background as a physician, economist, former University of Rochester medical school dean, and former president of the University of Florida Health System, Dr. Guzick shows that what we commonly refer to as the US health care "system" is actually an industry forged by a unique collection of self-interested and disjointed stakeholders. He argues that the assumptions underlying well-functioning markets do not align with health care. The resulting market imperfections, combined with entrenched industry stakeholders, have led to a significant imbalance of care, cost, and access.

Using a nontechnical framework, Dr. Guzick introduces readers to the economic principles behind the function—and dysfunction—of our health care industry. He shows how the market-based approach could be expected to remedy these problems while detailing the realities of imperfections, regulations, and wealth inequality on those functions. He also analyzes how this industry developed, presenting the conceptual underpinnings of the health care industry while detailing its history and tracing the creation and entrenchment of the current federation of key stakeholders—government, insurance companies, hospitals, doctors, employers, and drug and device manufacturers. In the final section of the book, Dr. Guzick looks to the future, describing the prevention, innovation, and alternative financing models that could help to rebalance the priorities of care, cost, and access that Americans need.

An online supplement on COVID-19 is available, as is a discussion guide for instructors. To access this supplemental material, please visit www.jhupbooks.press.jhu.edu.

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An Introduction to the US Health Care Industry

David S. Guzick, MD, PhD

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Combining the expert perspective of an economist with that of a hands-on caregiver and senior leader of top health care institutions, this unique book should be read by any student of health care policy.

About

Book Details

Publication Date
Status
Available
Trim Size
7
x
10
Pages
584
ISBN
9781421438658
Illustration Description
70 line drawings
Table of Contents

Preface
Acknowledgments
Chapter 1. Setting the Stage: Health and Health Care over the Past Century

Part I. Economic Underpinnings
Chapter 2. Perfect Competition and Its Applicability to Health Care

Preface
Acknowledgments
Chapter 1. Setting the Stage: Health and Health Care over the Past Century

Part I. Economic Underpinnings
Chapter 2. Perfect Competition and Its Applicability to Health Care Services
Chapter 3. Imperfections in the Market for Health Care Services
Chapter 4. Implications of an Imperfect Market I: Greater Utilization Due to Price Subsidies
Chapter 5. Implications of an Imperfect Market II: The Role of Induced Demand
Chapter 6. The Role of Price in Health Care Spending Growth
Chapter 7. Inequality of Wealth, Health, and Access to Care

Part II. Historical Evolution
Chapter 8. Origins and Structural Underpinnings of the US Health Care Industry
Chapter 9. The US Health Care Industry Takes Shape: The 1940s through 1965
Chapter 10. Medicare
Chapter 11. Medicaid
Chapter 12. The Affordable Care Act

Part III. Contemporary Environment
Chapter 13. Evidence-Based Practice
Chapter 14. Cost-Benefit, Cost-Effectiveness, and Cost-Utility Analysis
Chapter 15. Health Care Law
Chapter 16. The Safety and Quality of Patient Care
Chapter 17. The Cost Conundrum I: Utilization
Chapter 18. The Cost Conundrum II: Price: Administration, Insurers, Physicians, and Hospitals
Chapter 19. The Cost Conundrum III: Price: Pharmaceuticals and Medical Devices
Chapter 20. Inequality of Access

Part IV. Improving the Balance of Care, Cost, and Access
Chapter 21. Improving the Balance I: Macro Considerations
Chapter 22. Improving the Balance II: Enhancing Care, Reducing Cost, and Improving Access

References
Index

Author Bio
Featured Contributor

David S. Guzick, MD, PhD

David S. Guzick, MD, PhD, a former senior vice president for health affairs and the president of UF Health, is a professor of obstetrics-gynecology and health services research and management at the University of Florida.
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