The volume is arranged in five chapters: current challenges to the health care system; health insurance; health care providers; chronic illness and AIDS: future challenges for the American health care system; and health policy and thoughts on reform. The first and last chapters contain articles that provide broad overviews of the health care system and reform of American health care. Chapters 2-4 acquaint the reader with the literature dealing with the nuts and bolts of how the system works. This book provides a guide to the sources of background information necessary to understand the need for reform, to sources on the complexities and issues that must be dealt with for effective reform, and to discussions of reform itself. This is also a guide to major databases and prominent authorities.
The physician is the key figure in health care, and how physicians are organized is central to the health care system, says Robinson. He focuses on four forms of physician organization to illustrate how external pressures have led to health care innovations: multispecialty medical groups, Independent Practice Associations (IPAs), physician practice management firms, and physician-hospital organizations. These physician organizations have evolved in the past two decades by adopting from the larger corporate sector similar forms of ownership, governance, finance, compensation, and marketing.
In applying economic principles to the maelstrom of health care, Robinson highlights the similarities between competition and consolidation in medicine and in other sectors of the economy. He points to hidden costs in fee-for-service medicine—overtreatment, rampant inflation, uncritical professional dominance regarding treatment decisions—factors often overlooked when newer organizational models are criticized.
Not everyone will share Robinson's appreciation for market competition and corporate organization in American health care, but he challenges those who would return to the inefficient and inequitable era of medicine from which we've just emerged. Forcefully written and thoroughly documented, The Corporate Practice of Medicine presents a thoughtful—and optimistic—view of a future health care system, one in which physician entrepreneurship is a dynamic component.
In "Shock Therapy for the American Health Care System: Why Comprehensive Reform Is Needed," Dr. Robert Levine offers an easily understandable diagnosis of the problems plaguing our current health care infrastructure, with discussions that include the roles of various stakeholders--insurance companies, "big pharma," hospitals, health care providers, and patients. He also dispels a number of myths designed to make voters leery of any reform efforts. Levine's comprehensive plan addresses everything from bloated bureaucracies to unnecessary procedures to the handling of negligence and malpractice lawsuits/claims. Throughout, Levine backs his proposals with facts and comparisons to systems in various countries, and concludes that even now, with disaster looming, the ultimate goal of providing health insurance for every American is achievable and affordable.
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