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El. knyga: Call to Be Whole: The Fundamentals of Health Care Reform

  • Formatas: 240 pages
  • Išleidimo metai: 30-Jul-2003
  • Leidėjas: Praeger Publishers Inc
  • Kalba: eng
  • ISBN-13: 9780313072468
  • Formatas: 240 pages
  • Išleidimo metai: 30-Jul-2003
  • Leidėjas: Praeger Publishers Inc
  • Kalba: eng
  • ISBN-13: 9780313072468

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Examines the complex interrelationships that inform the health care system. Health care, like all social systems, is a product of thought. Up to now, our collective thinking has been based on trying to manage parts, not the whole. This book inquires into four age-old questions that shape all health care systems: What is health? What is care? Who is responsible? How much is enough?

Americans have the wealthiest health care system in the world, yet the health status of Americans ranks in the lowest quartile among the world's 25 industrialized nations and 45 million Americans are without health insurance. Today's cost, quality, and access problems are inter-related and can be traced to taken-for-granted assumptions and health care's outmoded organizing concepts: reductionism and materialism. Greater fragmentation of care, an over-dependence on technology, inattention to social and environmental determinants of health, and serious economic and moral dilemmas are some of the results of the last 40 years of piecemeal political and economic reform.

This book has three purposes. The first is to help the reader see healthcare as a complex system—a part in a larger whole—and to show how answers to the questions, What is health? What is care? Who is responsible? How much is enough? implicitly define the purpose, effectiveness, efficiency, and fairness of a health care system. The second is to show that today's access, cost, and quality problems are interrelated, and arise from outmoded concepts, unquestioned assumptions, and a long trail of inconsistent and contradictory answers to the four questions. The third purpose is to acquaint readers with both the personal and societal challenges of finding coherent answers to the four questions raised above and to describe some of the budding experimental solutions that challenge traditional conventions and assumptions.



Examines the complex interrelationships that inform the health care system. Health care, like all social systems, is a product of thought. Up to now, our collective thinking has been based on trying to manage parts, not the whole. This book inquires into four age-old questions that shape all health care systems: What is health? What is care? Who is responsible? How much is enough?

Examines the complex interrelationships that inform the health care system. Health care, like all social systems, is a product of thought. Up to now, our collective thinking has been based on trying to manage parts, not the whole. This book inquires into four age-old questions that shape all health care systems: What is health? What is care? Who is responsible? How much is enough?

Americans have the wealthiest health care system in the world, yet the health status of Americans ranks in the lowest quartile among the world's 25 industrialized nations and 45 million Americans are without health insurance. Today's cost, quality, and access problems are inter-related and can be traced to taken-for-granted assumptions and health care's outmoded organizing concepts: reductionism and materialism. Greater fragmentation of care, an over-dependence on technology, inattention to social and environmental determinants of health, and serious economic and moral dilemmas are some of the results of the last 40 years of piecemeal political and economic reform.

This book has three purposes. The first is to help the reader see healthcare as a complex system—a part in a larger whole—and to show how answers to the questions, What is health? What is care? Who is responsible? How much is enough? implicitly define the purpose, effectiveness, efficiency, and fairness of a health care system. The second is to show that today's access, cost, and quality problems are interrelated, and arise from outmoded concepts, unquestioned assumptions, and a long trail of inconsistent and contradictory answers to the four questions. The third purpose is to acquaint readers with both the personal and societal challenges of finding coherent answers to the four questions raised above and to describe some of the budding experimental solutions that challenge traditional conventions and assumptions.



Examines the basic assumptions that underlie the organization of the modern health care system and illuminates the layers of systemic dysfunction that result in today's cost, quality, and access problems.

Americans have the wealthiest health care system in the world. Yet the health status of Americans ranks in the lowest quartile among the world's 25 industrialized nations, and 45 million Americans are without health insurance. Greater fragmentation of care, an over-dependence on technology, inattention to social and environmental determinants of health, and serious economic and moral dilemmas are only some of the results of piecemeal political and economic reform in the last 40 years.

Arguing that every system of health care is organized according to its society's prevailing worldview and its social institutions, Sowada examines U.S. health care from the perspective of systems thinking, finding the very conceptual underpinnings to be unstable and dysfunctional. Identifying the precept that the part is greater than the whole as the current and unhealthy guiding principle of American health care, she argues instead for a more holistic worldview that would lead to such reforms as a national health service with a global budget and greater attention to social, environmental, and behavioral determinants of health. Annotation (c) Book News, Inc., Portland, OR (booknews.com)

Examines the complex interrelationships that inform the health care system. Health care, like all social systems, is a product of thought. Up to now, our collective thinking has been based on trying to manage parts, not the whole. This book inquires into four age-old questions that shape all health care systems: What is health? What is care? Who is responsible? How much is enough?

Americans have the wealthiest health care system in the world, yet the health status of Americans ranks in the lowest quartile among the world's 25 industrialized nations and 45 million Americans are without health insurance. Today's cost, quality, and access problems are inter-related and can be traced to taken-for-granted assumptions and health care's outmoded organizing concepts: reductionism and materialism. Greater fragmentation of care, an over-dependence on technology, inattention to social and environmental determinants of health, and serious economic and moral dilemmas are some of the results of the last 40 years of piecemeal political and economic reform.

This book has three purposes. The first is to help the reader see healthcare as a complex system—a part in a larger whole—and to show how answers to the questions, What is health? What is care? Who is responsible? How much is enough? implicitly define the purpose, effectiveness, efficiency, and fairness of a health care system. The second is to show that today's access, cost, and quality problems are interrelated, and arise from outmoded concepts, unquestioned assumptions, and a long trail of inconsistent and contradictory answers to the four questions. The third purpose is to acquaint readers with both the personal and societal challenges of finding coherent answers to the four questions raised above and to describe some of the budding experimental solutions that challenge traditional conventions and assumptions.

Daugiau informacijos

Examines the basic assumptions that underlie the organization of the modern health care system and illuminates the layers of systemic dysfunction that result in today's cost, quality, and access problems.
ILLUSTRATIONSILLUSTRATIONSIllustrations FIGURES1.1.Quest to Maximize Profits 41.2.Technology and Fee-for-Service Reimbursement Reinforce Each Other's Growth 112.1.Health Care Is Both a Part and a Whole 242.2.Differences between Modern and Postmodern Worldviews 262.3.Health Care As a Cultural Box 312.4.Basic Pattern of Health Care Systems 362.5.Flood's Holistic Prism 372.6.A Congruent Health Care System Is One Whose Cover Fits Its Frame 373.1.Distribution of Determinants of Health 534.1.The Current Health Care System: Elements Product 634.2.Continuum of States 674.3.Integration of States of Health with Forms of Care 844.4.Needs and Remedies Collapsed into Acute Care and Medical Technology 845.1.Efficiency and Effectiveness Are Out of Alignment 925.2.Feedback Loops among Modernity, the Market Economy, and Health Care Generate Multiple, Interlocking Vicious Cycles 975.3.Benefit-Utilization Curve 1085.4.Boundaries Prevent Uncontrolled Growth 1115.5.Modern versus Postmodern Perception of Health Care 1126.1.The Nation's Health Dollar, 2000 1437.1.Human-Made Systems, Thought, and Behavior Are Mutually Reinforcing 1619.1.The Market Economy and Health Care Are Derived from a Worldview, and All Emerge from Human Thought 203 TABLES3.1.Comparison of the Definitions of Health 544.1.Inputs, Outputs, and Objects of Care 825.1.How the United States Stacks Up Internationally 915.2.Health Expenditures, Life Expectancy, and Percentage of Elderly, Selected Countries 1035.3.Modern versus Postmodern Understanding of Health Care 1097.1Axes of Change in the U.S. Health Care System 153
BARBARA J. SOWADA is a fellow in the Healthcare Forum's Healthier Communities Fellowship.