You are an employee of a think tank in Washington, DC. The director has been asked to testify before a congressional committee on the following question: In reforming the ACA, what lessons should the United States learn from relevant experience abroad? Your job is to write a memorandum that will help the director answer this question. In writing this memo, you should address the following questions:
1. How can learning from abroad help policy makers engage in a process of self-examination of health policy at home?
2. Compare the NHS and NHI systems.
3. What should members of Congress know about China’s problems and
aspirations in health policy?
4. What lessons from abroad would be most relevant in reforming the U.S. health system?
BRIEF CONTENTS
PART I HEALTH POLICY
CHAPTER 1 The Challenge of Health Care Delivery and Health Policy
CHAPTER 2 Organization of Care
CHAPTER 3 The Politics of Health Care in the United States
CHAPTER 4 Comparative Health Systems
PART II KEEPING AMERICANS HEALTHY
CHAPTER 5 Population Health
CHAPTER 6 Public Health: A Transformation in the 21st Century
CHAPTER 7 Health and Behavior
CHAPTER 8 Vulnerable Populations: Meeting the Health Needs of Populations Facing Health Inequities
PART III MEDICAL CARE: TREATING AMERICANS’ MEDICAL PROBLEMS
CHAPTER 9 The Health Workforce
CHAPTER 10 Health Care Financing
CHAPTER 11 Health Care Costs and Value
CHAPTER 12 High-Quality Health Care
CHAPTER 13 Health Care Management
CHAPTER 14 Health Information Technology
PART IV FUTURE OF U.S. HEALTH CARE
CHAPTER 15 The Future of Health Care Delivery and Health Policy
APPENDIX U.S. Government Public Health Agencies
GLOSSARY
Jonas & Kovner’s
HEALTH CARE DELIVERY IN THE UNITED STATES
James R. Knickman, PhD, is the Robert Derzon Chair in Public and Health Affairs at New York University with joint appointments at the NYU Wagner School of Public Service and at NYU Langone Medical School’s Department of Population Health. He has spent four decades splitting his time between academe and the philanthropic sector. His work focuses on health policy and he has played many roles both as a researcher and a leader in philanthropy to advance the use of public policy to improve the American health care system. He was a Vice President at the Robert Wood Johnson Foundation and President of the New York State Health Foundation. He has a PhD in Public Policy Analysis from the University of Pennsylvania and did his undergraduate work at Fordham University. He serves on the Board of Directors at three non-profit organizations, including chairing the National Council on Aging.
Brian Elbel, PhD, MPH, is an associate professor of Population Health and Health Policy at the New York University School of Medicine, where he heads the Section on Health Choice, Policy and Evaluation within the Department of Population Health, and at the NYU Wagner Graduate School of Public Service. He is the Assistant Dean for Strategic Initiatives in the Office of Science and Research of NYU Langone Health and the Director of the NYU Langone Comprehensive Program on Obesity. He studies how individuals make decisions that influence their health, with a particular emphasis on evaluation, obesity, and food choice. His work uses behavioral economics to understand health decision-making among vulnerable groups, and the role and influence of public policy on these decisions. His research has been funded by the National Institutes of Health, Centers for Disease Control and Prevention, the National Science Foundation and the Robert Wood Johnson Foundation and has been featured in national television, radio, and print media. Dr. Elbel earned his bachelor’s degree from The University of Texas at Austin and his master’s and doctorate in Health Policy/Health Economics from Yale University.
Jonas & Kovner’s
HEALTH CARE DELIVERY IN THE UNITED STATES
12th Edition
EDITORS JAMES R. KNICKMAN, PhD BRIAN ELBEL, PhD, MPH
FOUNDING EDITOR STEVEN JONAS, MD, MPH, MS, FNYAS
Copyright © 2019 Springer Publishing Company, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Springer Publishing Company, LLC, or authorization through payment of the appropriate fees to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, 978–750-8400, fax 978–646-8600, [email protected] or on the Web at www.copyright.com. Springer Publishing Company, LLC 11 West 42nd Street New York, NY 10036 www.springerpub.com connect.springerpub.com Acquisitions Editor: David D’Addona Compositor: Integra ISBN: 9780826172723 ebook ISBN: 9780826172730 DOI: 10.1891/9780826172730 INSTRUCTOR’S MATERIALS: Qualified instructors may request supplements by emailing [email protected]: Instructor’s Manual: 9780826172914 PowerPoints: 9780826172747 Test Bank: 9780826172761 Transition Guide for the 12th Edition: 9780826172785 Image Bank: 9780826172778 Syllabus for Public Health: 9780826172938
Syllabus for Nursing: 9780826172945 Supplementary materials are available from http://connect.springerpub.com/content/book/978-0-8261-7273-0 The Affordable Care Act: An Update The Affordable Care Act: A Brief History, Assessment, and Future Challenges Provisions of the Patient Protection and Affordable Care Act of 2010 eChapter: A Visual Overview of Health Care Delivery in the United States Case Exercises for Nurses For Students and Instructors: Visit ushealthcaredelivery.com for additional materials including an update on the Affordable Care Act. 18 19 20 21 22/5 4 3 2 1 The author and the publisher of this Work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. The author and publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information contained in this book. The publisher has no responsibility for the persistence or accuracy of URLs for external or third-party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Library of Congress Cataloging-in-Publication Data Names: Knickman, James, editor. | Elbel, Brian, [date] editor. Title: Jonas & Kovner’s health care delivery in the United States / [edited
by] James R. Knickman, Brian Elbel. Other titles: Jonas and Kovner’s health care delivery in the United States |
Health care delivery in the United States Description: 12th edition. | New York : Springer Publishing Company,
[2019] | Includes bibliographical references and index. Identifiers: LCCN 2018048861 (print) | LCCN 2018049494 (ebook) | ISBN
9780826172730 | ISBN 9780826172723 (alk. paper) | ISBN 0826172725
(alk.paper) Subjects: | MESH: Delivery of Health Care | Health Services | Health Policy
| Quality of Health Care | United States Classification: LCC RA395.A3 (ebook) | LCC RA395.A3 (print) | NLM W
84 AA1 | DDC 362.10973—dc23 LC record available at https://lccn.loc.gov/2018048861
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CONTENTS List of Features Foreword by Anthony R. Kovner, PhD Acknowledgments Organization of This Book Contributors Share Jonas & Kovner’s Health Care Delivery in the United
States, 12th Edition
PART I HEALTH POLICY
Chapter 1 The Challenge of Health Care Delivery and Health Policy
Brian Elbel and James R. Knickman Introduction The Importance of Good Health to American Life Defining Characteristics of the U.S. Health System Major Issues and Concerns Key Stakeholders Influencing the Health System Organization of This Book Conclusion Case Exercise—Health Care Delivery Plan Discussion Questions Reference
Chapter 2 Organization of Care Amy Yarbrough Landry and Cathleen O. Erwin
Introduction Description of the Current Care Delivery System The Future of the Delivery System Best Practices Conclusion Case Exercise—Innovative Ideas Discussion Questions References
Chapter 3 The Politics of Health Care in the United States
Rogan Kersh and James Morone Introduction Health Care Infrastructure and Spending: Many Dollars, to
What Effect? Who Pays? The Politics of Medicare, Medicaid, and Much
More The Politics of Providing Equitable Health Services How Personal Health Decisions Become Public: The Case of
Obesity Conclusion: Better National Health Ahead? Case Exercise—Insurance Plans Discussion Questions References
Chapter 4 Comparative Health Systems Michael K. Gusmano and Victor G. Rodwin Introduction Health System Models NHS and NHI Systems Compared With the United States The Health Systems in England, Canada, France, and China Lessons Case Exercise—European Lessons Learned
Discussion Questions References
PART II KEEPING AMERICANS HEALTHY
Chapter 5 Population Health Pamela G. Russo and Marc N. Gourevitch Introduction The Population Health Model The Medical Model Comparing the Medical and Population Health Models The Influence of Social Determinants on Health Behavior and
Outcomes Leading Determinants of Health: Weighting the Different
Domains Health Policy and Returns on Investment Conclusion Case Exercise—Sodium and its Effects on Our Health Discussion Questions References
Chapter 6 Public Health: A Transformation in the 21st Century
Laura C. Leviton, Paul L. Kuehnert, and Kathryn E. Wehr Overview of a Complex Infrastructure Public Health Requires a Collective Response from Society Public Health is Different from Individual Health Care The Core Functions of Public Health Define Essential Public
Health Activities Governmental Agencies Have Legal Authority for the Core
Functions Social, Economic, and Political Forces are
Transforming Public Health
Conclusion Case Exercise—Cure For Birth Defects Policy Options Discussion Questions References
Chapter 7 Health and Behavior Brian Elbel, Elaine F. Cassidy, Matthew D. Trujillo, and C.
Tracy Orleans Introduction Behavioral Risk Factors: Overview and National Goals Changing Health Behavior: Closing the Gap Between
Recommended and Actual Health Lifestyle Practices The Role and Impact of Primary Care Interventions Multilevel Models For Population-Based Health Behavior
Change Changing Provider Behavior: Closing the Gap Between Best
Practice and Usual Care Conclusion Case Exercise—Comprehensive Plan for Addressing Risk
Factors Discussion Questions References
Chapter 8 Vulnerable Populations: Meeting the Health Needs of Populations Facing Health Inequities
Monique J. Vasquez, Jacqueline Martinez Garcel, Elizabeth A. Ward, and Lourdes J. Rodríguez
Introduction Understanding Factors and Systems that Impact People
Disproportionately Affected by Health Inequities The Growing Number of Health Inequities
Uneven Footing After the Great Recession and a Strained Social Service Sector
Organization and Financing of Health Care, Population/Public Health/Prevention, and Other Services for Populations Experiencing Health Inequities
Rural Health Clinics and Rural Health Networks Social Service Needs Federal and State Financing of Care for Vulnerable
Populations Challenges for Service Delivery and Payment Emerging and Tested Ideas for Better Health Delivery Case Exercise 8.1—Patient Engagement: Bronx-Lebanon
Hospital Department of Family Medicine’s Patient-Centered Medical Home
Case Exercise 8.2—Integrated Care: Camden Coalition of Health Care Providers
Opportunities in the ACA to Meet Health Care Needs of Vulnerable Populations
Conclusion Case Exercise 8.3—Plan for Refugees Discussion Questions References
PART III MEDICAL CARE: TREATING AMERICANS’ MEDICAL PROBLEMS
Chapter 9 The Health Workforce Joanne Spetz and Susan A. Chapman Introduction Who Is Part of the Health Workforce? Traditional Approaches to Health Workforce Planning Health Workforce Education Critical Issues for the Health Workforce
Conclusion: Building the Future Health Care Workforce Case Exercise—Workforce Recruitment Plan Discussion Questions References
Chapter 10 Health Care Financing James R. Knickman Introduction General Overview of Health Care Financing What the Money Buys and Where It Comes From How Health Insurance Works How Providers are Paid for the Health Services They Deliver Specialized