Introduction to U.S. Health Policy

This text covers the organization, financing, and delivery of health care in America, looking at factors that have shaped health care and the consequences of the American approach to health care. It explores the roles of medicine and nursing as shapers of the system as well as providers of care, and examines the American obsession with medical care as a market good rather than a public good. It discusses problems that have resulted from the rise of managed care and the impact of this system on those without health insurance, and looks at other factors which affect access to care. Barr teaches sociology and human biology at Stanford University. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Doody Review Services

Reviewer:Mark M. Liebow, MD(Mayo Clinic)
Description:This is an introduction to organizations and institutions in the American healthcare system that reviews the history of the system and how well it works. With key concepts before each chapter, this is a primer that could be used for a survey course.
Purpose:There is always a place for a good introduction to health policy. This book for the most part meets the author's goal of explaining the history of the system but is less successful at explaining how well the system works.
Audience:This could help anyone with minimal knowledge of health policy, but would be best as supplementary reading for an introductory health policy course for college or medical students. The author has clinical and academic expertise with experience teaching introductory courses in health policy.
Features:The book starts with a 65-page overview of the organization of the healthcare system, then 100 pages about how care is paid for. The last 70 pages cover a variety of topics. The breadth of coverage in such a short book is substantial. The tables and figures are helpful and clear. As in most introductory books, depth is sacrificed. There is unevenness in coverage that is hard to understand. Some material of minimal interest to policy novices gets lots of space while other material is slighted.
Assessment:This is a useful addition to the literature on healthcare policy. It provides a brief and broad, if superficial, overview. Anyone wishing more on a specific topic will need another book. Clinicians may prefer Bodenheimer and Grumbach's Understanding Health Policy: A Clinical Approach, 3rd edition (McGraw-Hill, 2002) and those wanting more detail in an overview may prefer Health Care Policy by Calkins et al. (Blackwell Publishing, 1995), though the latter is a bit dated.