Health Care In The United States: Organization, Management, And Policy

HEALTH CARE IN THE UNITED STATES ORGANIZATION, MANAGEMENT, AND POLICY H O W A R D P. G R E E N W A L D HEALTH CARE IN THE UNITED STATES Organization, Management, and Policy H O W A R D P. G R E E N W A L D Copyright © 2010 by John Wiley & Sons, Inc. All rights reserved. Published by Jossey-Bass A Wiley Imprint 989 Market Street, San Francisco, CA 94103-1741—www.josseybass.com No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600, or on the Web at www.copyright.com. Requests to the publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, 201-748-6011, fax 201-748-6008, or online at www.wiley.com/go/permissions. Readers should be aware that Internet Web sites offered as citations and/or sources for further information may have changed or disappeared between the time this was written and when it is read. Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages. Jossey-Bass books and products are available through most bookstores. To contact Jossey-Bass directly call our Customer Care Department within the U.S. at 800-956-7739, outside the U.S. at 317-572-3986, or fax 317-572-4002. Jossey-Bass also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. Library of Congress Cataloging-in-Publication Data has been applied for. Printed in the United States of America first edition ISBN 9780787995478 HB Printing 10 9 8 7 6 5 4 3 2 1 CONTENTS Tables and Figures vii Preface xi The Author xv Acknowledgments PART ONE THE SYSTEM AND ITS TASKS xvi 1 1 UNDERSTANDING HEALTH CARE Health Care as a National Concern Health Care Objectives and Goals Essential Challenges in Health Care Public Trust and Professional Ethics Three Perspectives on Management and Policy 3 4 8 9 13 15 2 THE U.S. HEALTH CARE SYSTEM: FEATURES, DEVELOPMENT, AND CONTROVERSIES The U.S. Health Care System’s Magnitude Uniqueness of the System American Values and Health Care Controversies in U.S. Health Care 19 20 20 29 35 MAJOR HEALTH PROBLEMS IN MODERN SOCIETY Conceptions of Health and Disease The Causes of Disease Nondisease Threats to Health, Function, and Survival Epidemiology: The Science of the Denominator Health and Illness in the Twenty-First Century Future Threats to Health 41 42 49 55 56 62 68 3 iv 4 Contents HUMAN BEHAVIOR, HEALTH, AND HEALTH CARE The Behavioral Dimension The Concept of the Sick Role Health Risk Behavior Use of He