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Product details
File Size: 3760 KB
Print Length: 272 pages
Publisher: PublicAffairs; 1 edition (November 5, 2013)
Publication Date: November 5, 2013
Language: English
ISBN-10: 1610392108
ISBN-13: 978-1610392105
ASIN: B00E257VKG
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Amazon Best Sellers Rank:
#158,220 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
This is a must read for any scholar or practitioner of public health. By far the best book that has articulated the history of how our social service infrastructure was bifurcated from healthcare and relegated to an underfunded and discretionary industry. Meanwhile, healthcare became dominant via a powerful medical lobby that thrived on an entitlement program for the middle class with substantial inefficiency and minimal accountability for improved health and community well-being. The book makes a great case that our ability to improve health is not simply through the traditional approaches of managed care, tort reform, and insurance regulations; rather, it's through a concerted effort to invest in social supports to enhance social determinants
This thought provoking and paradigm-shifting book is a must read for anyone interested in the American healthcare system. Bradley and Taylor have hit on an idea that is clear, simple and obvious (so much so that readers may be embarrassed for not having discovered the idea first). The “American Healthcare Paradox†of why America spends comparatively so much on healthcare yet receives so little is unraveled when social spending is considered: America comparatively spends an average amount on the sum of medical and social spending and therefore has middling results. Incorporating a more holistic view of expenditure on the broader determinants of health solves the paradox.Some may find the book frustrating because it aims to shift the focus of the discussion, rather than provide quick and easy answers. This is precisely the value of the book. Our current situation is complicated, and the overall underperformance cannot be improved easily or quickly. A successful approach to the problem requires a shift in the public discussion and a collective acknowledgement of our shared burden in causing this issue. Bradley and Taylor include an apolitical and helpful history of how the American system developed into its current form.While I find myself more towards the individualistic (vs. community orientation) side of the spectrum than Bradley and Taylor, their arguments have caused me to currently question and challenge my own assumptions. No matter your current views, this book is likely to have a similar effect on all readers.
Insightful reasoning into the US health care disaster. Illustrates the need for increased social services to mitigate medicalization. If include social services in the definition of health care the US and other developed countries spend the same but the US as poorer results.
So far it's a fantastic description of the healthcare system and the theories behind the US falling behind. Offers insight for why the US is falling behind, and offers solutions for where to focus out efforts as a nation and in the public health fields.
Good book, presented a superficial analysis of America’s healthcare spending problem with very idealistic solutions that often don’t work outside of a single payer system. Didn’t address social structures of oppression. However did give a good history of the evolution of insurance companies in US.
This book takes no shortcuts, and directly addresses the heart of an enormous issue in contemporary America. The American Health Care Paradox analyzes the wide range of graphs and statistics, as well as past strategies and interventions, that evidence America's commitment to creating a healthy population. However, when presented with the evident subpar health outcomes, Bradley and Taylor do not--unlike most others--insist that we throw more money at the issue. Instead, the authors dig deeper to discover the earliest roots of negative health outcomes, and specifically discusses how we can adjust our spending to better solve the problems we are faced with. Using research from countless other countries--especially Scandinavian ones, which consistently produce some of the best healthcare outcomes--Dr. Bradley and Ms. Taylor present convincing evidence that we can improve healthcare outcomes by (paradoxically) shifting spending away from health services, and instead towards sectors that function as highly efficient interventions: employment and housing programs; disability, sickness, and unemployment benefits; family and housing support; pensions, and perhaps most importantly, education.This book teaches the critical message that with a problem as complex as healthcare, there will be no easy solutions or shortcuts. We need to take a step back to acknowledge and address the societal factors that burden our healthcare system, because they are at the heart of our stunted healthcare outcomes.
Bradley does a masterful job of highlighting that low spending in social services in the US is one of the reasons that we have high spending on health care. She clearly lays out how the US social services and medical systems have evolved side by side with little interaction. However, if we look at health, a comprehensive model is George Engel's biopsychosocial model, and Bradley gets the bio and the social but forgets the psychological, the behavioral aspects of health. Indeed in one of her case examples she highlights a man who was quite wealthy who then makes a number of impulsive rash decisions and winds up uninsured and in poverty with a family member who has a chronic illness. Mental health services may have helped this individual before he bottomed out. We know that behavior accounts for at least half of the variance in health. Bradley does not address this at all in her book. From her point of view if all families had their basic needs met they would be much healthier, and she is right to a point. But there are still families who would be even healthier if they worked with a skilled mental health professional to address behaviors that are detrimental to health.
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