Health at Risk: America's Ailing Health System—and How to Heal It

Columbia University Press
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In this volume, the nation's leading advisors on health policy and financing appraise America's ailing healthcare system and suggest reasonable approaches to its rehabilitation. Each chapter confronts a major challenge to the country's health security, from runaway costs and uneven quality of care to declining levels of insurance coverage, medical bankruptcy, and the growing enthusiasm for health plans that put patients in charge of risk and cost. Bringing the latest research to bear on these issues, contributors diagnose the problems of our present system and offer treatments grounded in extensive experience. Free of bias and rhetoric, Health at Risk is an invaluable tool for those who are concerned with the current state of healthcare and are eager to effect change.
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About the author

Jacob Hacker is professor of political science at the University of California at Berkeley, where he heads the Center on Health and Economic Security at the Boalt Law School. A frequent media commentator and author of numerous scholarly and popular articles, he is the author of four books, most recently The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream. Contributors: Jacob Hacker: "Health Insecurity and the Middle Class"; Elizabeth McGlynn and David Meltzer: "Health Quality"; Brandon McKelvey and Jill Quadagno: "The Transformation of American Health Insurance"; Katherine Swartz: "The Uninsured and Underinsured"; Elizabeth Warren: "Medical Bankruptcy"
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Additional Information

Publisher
Columbia University Press
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Published on
Nov 6, 2008
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Pages
152
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ISBN
9780231518611
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Language
English
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Genres
History / United States / 20th Century
Medical / General
Medical / Health Care Delivery
Medical / Health Policy
Political Science / American Government / National
Political Science / General
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Content Protection
This content is DRM protected.
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Available on Android devices
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Eligible for Family Library

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The collapse of the financial markets in 2008 and the resulting 'Great Recession' merely accelerated an already worrisome trend: the shift away from an employer-based social welfare system in the United States. Since the end of World War II, a substantial percentage of the costs of social provision--most notably, unemployment insurance and health insurance--has been borne by employers rather than the state. The US has long been unique among advanced economies in this regard, but in recent years, its social contract has become so frayed that is fast becoming unrecognizable. Despite Obama's election, the burdens of social provision are falling increasingly upon individual families, and the situation is worsening because of the unemployment crisis. How can we repair the American social welfare system so that workers and families receive adequate protection and, if necessary, provision from the ravages of the market? In Shared Responsibility, Shared Risk, Jacob Hacker and Ann O'Leary have gathered a distinguished group of scholars on American social policy to address this most fundamental of problems. Collectively, they analyze how the 'privatization of risk' has increased hardships for American families and increased inequality. They also propose a series of solutions that would distribute the burdens of risks more broadly and expand the social safety net. The range of issues covered is broad: health care, homeownership, social security and aging, unemployment, wealth (as opposed to income) creation, education, and family-friendly policies. The book is also comparative, measuring US social policy against the policies of other advanced nations. Given the current crisis in America social policy and the concomitant paralysis within government, the book has the potential to make an important intervention in the current debate.
THE INSTANT NEW YORK TIMES BESTSELLER

"Sims’s vivid portrait of Trump shrewdly balances admiration with misgivings, and his intricate, engrossing accounts of White House vendettas and power plays have a good mix of immersion and perspective. The result is one of the best of the recent flood of Trump tell-alls." —Publishers Weekly

The first honest insider’s account of the Trump administration. If you hate Trump you need the truth; if you love Trump you need the truth.

After standing at Donald Trump’s side on Election Night, Cliff Sims joined him in the West Wing as Special Assistant to the President and Director of White House Message Strategy.

He soon found himself pulled into the President’s inner circle as a confidante, an errand boy, an advisor, a punching bag, and a friend. Sometimes all in the same conversation.

As a result, Sims gained unprecedented access to the President, sitting in on private meetings with key Congressional officials, world leaders, and top White House advisors. He saw how Trump handled the challenges of the office, and he learned from Trump himself how he saw the world.

For five hundred days, Sims also witnessed first-hand the infighting and leaking, the anger, joy, and recriminations. He had a role in some of the President’s biggest successes, and he shared the blame for some of his administration’s worst disasters. He gained key, often surprising insights into the players of the Trump West Wing, from Jared Kushner and John Kelly to Steve Bannon and Kellyanne Conway.

He even helped Trump craft his enemies list, knowing who was loyal and who was not.

And he took notes. Hundreds of pages of notes. In real-time.

Sims stood with the President in the eye of the storm raging around him, and now he tells the story that no one else has written—because no one else could. The story of what it was really like in the West Wing as a member of the President’s team. The story of power and palace intrigue, backstabbing and bold victories, as well as painful moral compromises, occasionally with yourself.

Team of Vipers tells the full story, as only a true insider could.

New York Times Bestseller

What are the consequences if the people given control over our government have no idea how it works?

"The election happened," remembers Elizabeth Sherwood-Randall, then deputy secretary of the Department of Energy. "And then there was radio silence." Across all departments, similar stories were playing out: Trump appointees were few and far between; those that did show up were shockingly uninformed about the functions of their new workplace. Some even threw away the briefing books that had been prepared for them.

Michael Lewis’s brilliant narrative takes us into the engine rooms of a government under attack by its own leaders. In Agriculture the funding of vital programs like food stamps and school lunches is being slashed. The Commerce Department may not have enough staff to conduct the 2020 Census properly. Over at Energy, where international nuclear risk is managed, it’s not clear there will be enough inspectors to track and locate black market uranium before terrorists do.

Willful ignorance plays a role in these looming disasters. If your ambition is to maximize short-term gains without regard to the long-term cost, you are better off not knowing those costs. If you want to preserve your personal immunity to the hard problems, it’s better never to really understand those problems. There is upside to ignorance, and downside to knowledge. Knowledge makes life messier. It makes it a bit more difficult for a person who wishes to shrink the world to a worldview.

If there are dangerous fools in this book, there are also heroes, unsung, of course. They are the linchpins of the system—those public servants whose knowledge, dedication, and proactivity keep the machinery running. Michael Lewis finds them, and he asks them what keeps them up at night.

A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 

"This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene  

At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems.

In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?

Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. 

The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
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