Cambridge University Press US Health Policy and Health Care Delivery: Doctors, Reformers, and Entrepreneurs

The unique composition and configuration of doctors and hospitals in the US is leading to a crisis in primary care provision. There are significantly more specialists than generalists, and many community hospitals and outpatient facilities are concentrated in affluent areas with high rates of comprehensive insurance coverage. These particular features present difficult challenges to policymakers seeking to increase access to care. Carl F. Ameringer shows why the road to universal healthcare is not built on universal finance alone. Policymakers in other countries successfully align finance with delivery to achieve better access, lower costs, and improved population health. This book explains how the US healthcare system developed, and why efforts to expand insurance coverage in the absence of significant changes to delivery will fuel higher costs without achieving the desired results. Review 'Anyone curious about why health care is so daunting in the United States will appreciate this well-researched, eminently readable summary of how it is delivered and financed.' Humayun J. Chaudhry, DO, MACP, President and CEO of Federation of State Medical Boards'In clear broad strokes, Ameringer offers a cogent analysis of how and why the US health care system came to be so different from the more effective and less costly systems that exist in every other economically advanced nation. Tracing the evolution of health care from the late nineteenth century through 2015, he identifies the kaleidoscopic combination of medical developments, socio-political policies, and uncoordinated financial programs that collectively produced the bloated and irrational arrangements now in place. This book should be read by all concerned citizens, by college classes, and especially by policymakers.' James C. Mohr, University of Oregon'In US Health Policy and Health Care Delivery: Doctors, Reformers, and Entrepreneurs, Carl F. Ameringer uses his combined expertise in health policy and law to bring to the fore an alternative explanation of why universal health care in the US remains elusive. He deftly weaves together a compelling argument that the ills of our current system are less the result of failures in insurance coverage than they are the historical evolution of how we deliver health care, focusing on high cost hospital and specialty care. His account deserves equal billing with the more pervasive account of health care financing and the book deserves a prominent place on the bookshelf of all serious health law and policy scholars and health care reformers.' Diane Hoffmann, University of Maryland'In this well-argued, thorough, and convincing analysis of inherited and invented problems in American health policy, Carl F. Ameringer presents this nation's health services as a hydra-headed monster of competing interests. Given the abundant historical evidence that partial solutions create new problems, effective policy proposals today must include broad support. A must-read for policy makers and the general public.' Rosemary Stevens, author of A Time of Scandal: Charles R. Forbes, Warren G. Harding and the Making of the Veterans Bureau'Ameringer takes on the timely topics of health care policy and delivery and examines them from a well-researched historical perspective to interrogate how and why the US health care system is different from systems of economically similar nations. Through this historical perspective, Ameringer argues that present-day policy changes will prove ineffective in lowering costs unless significant structural changes are made to how health care is delivered and organized. The book is generally organized chronologically and takes readers through the history of American health care, starting in the late 1800s. Ameringer writes in an approachable, engaging style that would be appropriate for an undergraduate audience. A brief index is included, but to fully understand the context of indexed subjects, read