Publications » Featured Books by Investigators:
|The Truth about Health Care: Why Reform Is Not Working in America|
|Rutgers University Press|
Show summary The United States spends greatly more per person on health care than any other country but the evidence shows that care is often poor and inappropriate. Despite expenditures of 1.7 trillion dollars in 2003, and growing substantially each year, services remain fragmented and poorly coordinated, and more than 46 million people are uninsured. Why can't America, with its vast array of resources, sophisticated technologies, superior medical research and educational institutions, and talented health care professionals, produce higher quality care and better outcomes?
In The Truth about Health Care, David Mechanic explains how health care in America has evolved in ways that favor a myriad of economic, professional, and political interests over those of patients. While money has always had a place in medical care, "big money" and the quest for profits has become dominant, making meaningful reforms difficult to achieve. Mechanic acknowledges that railing against these influences, which are here to stay, can achieve only so much. Instead, he asks whether it is possible to convert what is best about health care in America into a well functioning system that better serves the entire population.
Bringing decades of experience as an active health policy participant, researcher, teacher, and consultant to the public and private sectors, Mechanic examines the strengths and weaknesses of our system and how it has evolved. He pays special attention to areas often neglected in policy discussions, such as the loss of public trust in medicine, the tragic state of long-term care, and the relationship of mental health to health care.
For anyone who has been frustrated by uncoordinated health networks, insurance denials, and other obstacles to obtaining appropriate care, this book will provide a refreshing and frank look at the system's current and future dilemmas. Mechanic's thoughtful roadmap describes how health plans, healthcare professionals, policymakers, and consumer groups can work together to improve access, quality, fairness, and health outcomes in America.
About the Author:
David Mechanic is director of the Institute for Health, Health Care Policy, and Aging Research at Rutgers University and the national program director of the Robert Wood Johnson Foundation Investigator Awards in Health Policy Research. He has been elected to the National Academy of Sciences and to the Institute of Medicine. He was coeditor of Policy Challenges in Modern Health Care.
Linked Investigator Award(s):
|David Mechanic, Ph.D.||Economic Constraints, Trust and Evolving Patient-Provider Relationships|
Award Year: 1994
The public's trust in physicians is an essential aspect of health care delivery. As tensions grow between new medical possibilities and expenditure limits, innovative mechanisms are needed to settle disputes if litigation and other costly transactions are to be minimized. Dr. Mechanic uses trust as a conceptual frame to understand better evolving structures, possible mediating institutions, and the social and ethical implications of varying models of doctor-patient relationships. He examines strategies for rationing health care resources, achieving integration between acute and chronic disease models, and enhancing the compatibility of efforts to improve physical and behavioral health. The project synthesizes work on trust relations in medicine, building on theory and empirical research from several disciplines. Dr. Mechanic uses interviews and analysis of provider survey data to help extend the picture of how new practice arrangements affect trust. He also looks at how the English National Health Service makes and seeks to legitimize rationing decisions. Results shed light on the forces influencing medical care and suggest alternative approaches to inevitable dilemmas.
More Books by Author(s):
Mechanic, D., Mental Health and Social Policy: Beyond Managed Care, Fifth Edition. Boston: Allyn & Bacon, 2008.
Mechanic, D., Rogut, L., Colby, D., Knickman, J. editors, Policy Challenges in Modern Health Care. Rutgers University Press, 2005.
Mechanic, D., Managed Behavioral Health Care: Current Realities and Future Potential, 78. Jossey-Bass, Inc., 1998.