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The fourth edition of the essential guide to the contemporary US health care system.

Winner of the CHOICE Outstanding Academic Title of the Choice ACRL

Health care reform has been a dominant theme in public discourse for decades now. The passage of the Affordable Care Act was a major milestone, but rather than quell the rhetoric, it has sparked even more heated debate. In the latest edition of Introduction to US Health Policy, Donald A. Barr reviews the current structure of the American health care system, describing the historical and political contexts in which it developed and the core policy issues that continue to confront us today.

Barr’s comprehensive analysis explores the various organizations and institutions that make the US health care system work—or fail to work. He describes in detail the paradox of US health care—simultaneously the best in the world and one of the worst among developed countries—while introducing readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. Barr also discusses specific elements of US health care with depth and nuance, including insurance, especially Medicare and Medicaid. He scrutinizes the shift to for-profit managed care while analyzing the pharmaceutical industry, issues surrounding long-term care, the plight of the uninsured, the prevalence of medical errors, and the troublesome issue of nursing shortages.

The thoroughly updated edition of this widely adopted text focuses on the Affordable Care Act. It explains the steps taken to carry out the Act, the changes to the Act based on recent Supreme Court decisions, the success of the Act in achieving the combined goals of improved access to care and constraining the costs of care, and the continuing political controversy regarding its future. Drawing on an extensive range of resources, including government reports, scholarly publications, and analyses from a range of private organizations, Introduction to US Health Policy provides scholars, policymakers, and health care providers with a comprehensive platform of ideas that is key to understanding and influencing the changes in the US health care system.

Challenging students to think critically about the complex web of social forces that leads to health disparities in the United States.

The health care system in the United States has been called the best in the world. Yet wide disparities persist between social groups, and many Americans suffer from poorer health than people in other developed countries. In this revised edition of Health Disparities in the United States, Donald A. Barr provides extensive new data about the ways low socioeconomic status, race, and ethnicity interact to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term.

This thoroughly updated edition focuses on a new challenge the United States last experienced more than half a century ago: successive years of declining life expectancy. Barr addresses the causes of this decline, including what are commonly referred to as "deaths of despair"—from opiate overdose or suicide. Exploring the growing role geography plays in health disparities, Barr asks why people living in rural areas suffer the greatest increases in these deaths. He also analyzes recent changes under the Affordable Care Act and considers the literature on how race and ethnicity affect the way health care providers evaluate and treat patients.

As both a physician and a sociologist, Barr is uniquely positioned to offer rigorous medical explanations alongside sociological analysis. An essential text for courses in public health, health policy, and sociology, this compelling book is a vital teaching tool and a comprehensive reference for social science and medical professionals.

This book raises fundamental questions about the propriety of continuing to use a premedical curriculum developed more than a century ago to select students for training as future physicians for the twenty-first century. In it, Dr. Donald A. Barr examines the historical origins, evolution, and current state of premedical education in the United States.

One hundred years ago, Abraham Flexner's report on Medical Education in the United States and Canada helped establish the modern paradigm of premedical and medical education. Barr’s research finds the system of premedical education that evolved to be a poor predictor of subsequent clinical competency and professional excellence, while simultaneously discouraging many students from underrepresented minority groups or economically disadvantaged backgrounds from pursuing a career as a physician. Analyzing more than fifty years of research, Barr shows that many of the best prospects are not being admitted to medical schools, with long-term adverse consequences for the U.S. medical profession.

The root of the problem, Barr argues, is the premedical curriculum—which overemphasizes biology, chemistry, and physics by teaching them as separate, discrete subjects. In proposing a fundamental restructuring of premedical education, Barr makes the case for parallel tracks of undergraduate science education: one that would largely retain the current system; and a second that would integrate the life sciences in a problem-based, collaborative learning pedagogy. Barr argues that the new, integrated curriculum will encourage greater educational and social diversity among premedical candidates without weakening the quality of the education. He includes an evaluative research framework to judge the outcome of such a restructured system.

This historical and cultural analysis of premedical education in the United States is the crucial first step in questioning the appropriateness of continuing a hundred-year-old, empirically dubious pedagogical model for the twenty-first century.

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