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An overview of health care politics and policy, featuring both an historical review of the development of health care policy in the US, and an analysis of recent health care reform efforts. The book emphasises the role of the state and federal government, and the private sector in health policy.

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• List of Tables, and Figures
• Preface
• List of Abbreviations
• Chronology of Significant Events and Legislation in U.S. Health Care
• 1 Health Care Politics
• The Health Policy Environment
• Key Health Policy Actors
• Conclusion
• 2 Health Care Policy in the United States
• Health Care in the Nineteenth Century
• The Transformation of American Medicine: 1900-1935
• The Role of the Federal Government
• Expansion of Health Facilities and Services: 1930-1960
• Increasing Access to Health Care: The 1960s
• Efforts at Health Care Cost Containment: The 1970s to the 1980s
• The Reagan Administration
• George H.W. Bush Administration
• The Clinton Administration and Health Care Reforms
• George W. Bush Administration
• Presidential Election of 2004
• The Role of State and Local Governments in Health Care
• Conclusion
• Plan of the Book
• 3 Medicaid: Health Care for the Poor
• Program Objective and Structure
• Medicaid: Eligibility and Coverage, Services, and Benefits
• Major Trends in the Medicaid Program
• The Medicaid Program during the Reagan and Bush Years: 1980-1992
• Further Devolution of the Medicaid Program during the Clinton Administration: 1992-1998
• The Medicaid Program and the State Governments: Innovations and Experimentation, from the 1980s to the 1990s
• Medicaid Managed Care in the 1990s
• State Governments, Medicaid, and Children's Insurance Program
• Medicaid: Middle-Class Entitlement?
• Current Fiscal Crisis of Medicaid
• Medicaid Reform
• Conclusion
• 4 Medicare: Health Care for the Elderly and Disabled
• The Origins of Medicare
• Program Objectives and Structure
• Financing Medicare
• Supplementing Medicare
• Medicare, Balanced Budgets, and Managed Care
• The Disaster of the Medicare Catastrophic Coverage Act
• Controlling Costs
• The Problem of Long-Term Care
• Prescriptions and Change
• What Is in the Law
• Tenuous Future of Medicare
• Conclusion
• 5 Health Care and the Disadvantaged: Falling through the Cracks
• Equality and Equity
• Uninsured and Underinsured
• Profiling the Uninsured
• Consequences of Uninsurance or Underinsurance
• Insurance and the Idea of Community
• A Closer Look: The Poor, Minorities, and Women
• Solutions to the Problem of Uninsurance and Underinsurance
• Conclusion
• 6 Health Care Cost Containment
• Theoretical Framework: Government Regulation and Market Competition
• The Role of the Federal Government in Cost Containment
• State Governments and Cost Containment
• The Private Sector and Cost Containment
• A Strategy for Controlling Costs
• Conclusion
• 7 Medical Malpractice and Medical Liability
• Medical Errors, Medical Injury, and Patient Safety
• The Origins of Medical Malpractice
• Development of the Common Law in England
• Medical Malpractice and Liability in the United States
• The Current Tort System
• Criticisms of the Current Tort System
• Reforms and Alternatives
• Medical Liability: Federal Government Policy and Reforms
• Medical Liability Reforms at the State Level
• Effectiveness of Tort Reforms
• Medical Liability, Managed Care, Enterprise Liability, and ERISA
• Federal Patients' Bill of Rights
• Conclusion
• 8 Health Care Technology
• The Growth and Diffusion of Medical Technology
• Factors Responsible for the Growth of Medical Technologies
• Health Care Technology and Costs
• Medical Technology Assessment
• Current Status of Health Care Technology Assessment
• Managed Care and Health Care Technology
• Medical Technologies: Law, Politics, Religion, and Ethics to-Die
• Public Opinion and the Right to Die
• The Legacy of Terri Schiavo
• The Right-to-Die Movement
• Oregon's Death with Dignity Act
• Living Wills and Durable Power of Attorney
• Health Care Rationing
• Conclusion: Medical Technology, Ethics, and Public Policy
• 9 Reforming the System
• Systemic Problems
• The Economic Critique
• Moving toward Reform
• Health Care Reform on the Front Burner
• The States and Comprehensive Health Care Reform
• Conclusion
• 10 The Triumph of Incrementalism: From Managed Care to Consumer-Driven Health Care
• Retrenchment
• Covering Children
• Managed Care
• Managed Care Backlash
• The Public-Sector Response to Managed Care
• Back to the Market
• Consumer-Driven Health Care
• Conclusion
• 11 Conclusion: Health Care Policy at the Dawn of the Twenty-First Century
• Concluding Thoughts
• Appendix: State Medical Liability Laws
• Index

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CHOICE Review

Patel and Rushefsky address the politics of US health policy-making characterized by incrementalism and consensus building among diverse and conflicting interests. These well-qualified authors begin with their own biases, including a belief that health care is a "right." Definitions of health policy environment and key actors in the policy arenas are clear, used throughout, and helpful to the reader. This is an excellent integration of key legislation and political events that form the understanding of how the US health care system became what it is today. The historical overview of health care from the 19th century to the 1990s--as influenced and affected by issues of access, cost containment, and federal, state, and local governments--offers a background for understanding why the Clinton efforts have failed to date. Separate chapters on Medicaid, Medicare, services for the disadvantaged, cost containment, and the high costs of medical technologies are well written and easily understood, providing the lead into the final chapters on reforming the system and what health policy may look like in the 21st century, an incremental rather than a revolutionary approach. All levels.