Health Care Mess

If we can decode the human genome and fashion working machines out of atoms, why can't we navigate the quagmire that is our health care system? In this important new book, Julius Richmond and Rashi Fein recount the fraught history of health care in America since the 1960s. After the advent of Medicare and Medicaid and with the progressive goal to make advances in medical care available to all, medical costs began their upward spiral. Cost control measures failed and led to the HMO revolution, turning patients into consumers and doctors into providers. The swelling ranks of Americans without any insurance at all dragged the United States to the bottom of the list of industrialized nations.Over the last century medical education was also profoundly transformed into today's powerful triumvirate of academic medical centers, schools of medicine and public health, and research programs, all of which have shaped medical practice and medical care. The authors show how the promises of medical advances have not been matched either by financing or by delivery of care.As a new crisis looms, and the existing patchwork of insurance is poised to unravel, American leaders must again take up the question of health care. This book brings the voice of reason and the promise of compromise to that debate.

In this authoritative and thoughtful book you will find what we need to know if we are to do anything about health care in America., From their vast experience as both policymakers and respected scholars, Richmond and Fein have produced an authoritative account of the circumstances that created our present predicament and, more important, a thoughtful roadmap for how we can extricate ourselves from the quagmire. Their message is both practical and hopeful: the future of health care in this country is not 'preordained' by past decisions but will emerge from the choices still to be made. Their abiding optimism is both refreshing and timely., The book is a tour de force, a cogent, comprehensive and deeply informed review of the condition of the American health care system. Highly readable and carefully referenced, it is a guided tour over the very complex terrain of American health care, including the complexities and disparities that make its potential benefits unavailable to so many and so expensive to all. The authors' plan for universally available health care offers a basis for a renewed national debate around the ideal of equity and justice in our health care system. This wonderful book should be read by everyone interested in better health for the American population., Two of the giants of American medicine, public policy, and health policy have combined to produce a masterpiece detailing how our healthcare system came to be what it is, and how we can take it to the next level--providing quality care and access for all. It is must reading for students of medicine, public health and health policy., Rashi Fein and Julius Richmond bring a wealth of knowledge, long practical experience, and a welcome historical perspective to this excellent volume on the many aspects and causes of the steadily worsening health care crisis facing the nation. It's a continuing outrage that in today's America, the best and the worst in health care have existed side-by-side for so long in countless communities across the country. In this extraordinary era of nearly miracle-a-day new medical breakthroughs to prevent, treat, and even cure disease, inaction is unacceptable in the face of vast numbers of Americans with no health insurance, soaring inflation in the cost of health care, huge profits for the health insurance and pharmaceutical industries, and the very real danger of terrorist attacks with biological weapons. Genuine health reform is more urgent than ever, and the impressive recommendations of Fein and Richmond give us timely and important ideas about the direction such reform should take. Other modern nations have met and mastered this challenge, and America can too.

Julius B. Richmond, M.D., is a founder of Head Start and former Surgeon General under President Jimmy Carter. He is John D. MacArthur Professor of Health Policy, Emeritus, at Harvard University. Rashi Fein, Ph.D., was Professor of Medical Economics, Emeritus, at Harvard Medical School and the author of Medical Care, Medical Costs: The Search for a Health Insurance Policy. Jimmy Carter is former President of the United States. He was awarded the Nobel Peace Prize in 2002.