For decades, the United States has been faced with a puzzling problem: Despite spending much more money per capita on health care than any other developed nation, its population suffers from notoriously poorer health. In comparison with 10 other high-income nations, in fact, the US has the lowest life expectancy at birth, the highest rates of infant and neonatal mortality, and the most inequitable access to physicians when adjusted for need.
In An Introduction to the US Health Care Industry, Dr. David S. Guzick takes an in-depth look at this troubling issue. Bringing to bear his unique background as a physician, economist, former University of Rochester medical school dean, and former president of the University of Florida Health System, Dr. Guzick points out that what we commonly refer to as the US health care ""system"" can be more accurately thought of as an industry, historically forged by an internationally unique collection of self-interested and disjointed stakeholders. He argues that the assumptions underlying well-functioning markets do not hold with health care. The resulting market imperfections, he says, combined with entrenched industry stakeholders, have led to a significant imbalance of care, cost, and access.
Using a nontechnical framework, Dr. Guzick introduces readers to the economic principles behind the function'and dysfunction'of our health care industry. He shows how the market-based approach could be expected to work to remedy these problems while detailing the realities of imperfections, regulations, and even wealth inequality on those functions. He also analyzes how we came to have the industry that we do, presenting the conceptual underpinnings of the health care industry while detailing its history and tracing the creation and entrenchment of the current federation of key stakeholders'government, insurance companies, hospitals, doctors, employers, and drug and device manufacturers. In the final section of the book, Dr. Guzick looks to the future, describing the prevention, innovation, and alternative financing models that could help to rebalance the priorities of care, cost, and access that Americans need.
PrefaceAcknowledgments1. Introduction Setting the Stage: Health adn Health Care Over the Past CenturyPart 1: Economic Underpinnings2. Perfect Competition and its Applicability to Health Care Services3. Imprfections in the Market for Health Care Services4. Implications of an Imperfect Market: Greater Utilization Due to Price Subsidies5. Implications of an Imperfect Market: The Role of Induced Demand6. The Role of Price in Health Care Spending Growth7. Inequality of Wealth, Health, and Access to CarePart 2: Historical Evolution8. Origins and Structural Underpinnings of the U.S. Health Care Industry9. Thr U.S. Health Care Industry Takes Shape: The 1940s Through 196510. Medicare11. Medicaid12. The Affordable Care ActPart 3: Contemporary Environment13. Evidence-Based Practice14. Cost-Benefit, Cost-Effectiveness, and Cost-Utility Analysis15. Health Care Law16. The Safety and Quality of Patient Care17. The Cost Conundrum Utilization18. The Cost Conundrum Price: Administration, Insurers, Physicians, and Hospitals19. The Cost Conundrum Price: Pharmaceuticals and Medical Devices20. Inequality of AccessPart 4: Improving the Balance of Care, Cost, and Access21. Improving the Balance: Macro Considerations22. Improving the Balance: Enhancing Care, Reducing Cost, and Improving AccessIndex
