This comprehensive analysis introduces the various organizations and institutions that make the U.S. health care system work—or fail to work, as the case may be. A principal message of the book is the seeming paradox of the quality of health care in this country—on the one hand it is the best medical care system in the world, on the other it is one of the worst among developed countries because of how it is organized.
Barr introduces readers to broad cultural issues surrounding health care policy, such as access, affordability, and quality. He discusses specific elements of U.S. health care, including insurance, especially Medicare and Medicaid, the shift to for-profit managed care, the pharmaceutical industry, issues of long-term care, the plight of the uninsured, medical errors, and nursing shortages. The latest edition of this widely adopted text updates the description and discussion of key sectors of America’s health care system in light of the Affordable Care Act.
The health care system in the United States has been called the best in the world. Yet wide health disparities persist between different social groups, and many Americans suffer from poorer health than people in other developed countries. Donald A. Barr's Health Disparities in the United States explores how socioeconomic status, race, and ethnicity interact with socioeconomic inequality to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community, cultural subsets, and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term.
This popular course book, which has been fully updated, now incorporates significant new material, including a chapter on the profound effects of inequality on child development, behavioral choices, and adult health status. An essential text for courses in public health, health policy, and sociology, the second edition analyzes the complex web of social forces that influence health outcomes in the United States. This book is a vital teaching tool and a comprehensive reference for social science and medical professionals.
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.