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Posted on January 16, 2002

Understanding Health Policy - A Clinical Approach.

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Third Edition, 2002 Lange Medical Books/McGraw-Hill By Thomas S. Bodenheimer, M.D. and Kevin Grumbach, M.D.

"Perhaps no tension within the U.S. health care system is as far from reaching a point of satisfactory equilibrium as the achievement of a basic level of fairness in the distribution of health care services and the burden of paying for those services. Despite two years of intense debate on health care reform following the 1992 presidential election, more people in the country were uninsured in 2000 than in 1994, with prospects dim for attainment of universal coverage in this century. Due to persistent financial barriers, more patients will go without early detection of potentially curable cancers, more patients with chronic diseases will be hospitalized because of lack of timely outpatient care, more hypertensive patients will forego the medications that might avert the occurrence of strokes and kidney failure, and more babies will be born prematurely and spend their first weeks of life in a neonatal intensive care unit. The poor will continue to pay a greater proportion of their income for health care than do more affluent families, and catastrophic health care costs will ravage countless middle class families.

"People providing and receiving care in the United States must work together to achieve a brighter future for the nation's health care system. Changing the future will require that people look beyond their immediate self-interest to view the common good of a health care system that is accessible, affordable, and of high quality for all. A heightened level of public discourse will be needed, with a populace that is better informed and more actively engaged in shaping the future of their health care system. Abstract concepts in health policy will need to be discussed and debated in a manner that connects with the daily realities experienced by patients and caregivers. The attitudes and actions of physicians and other health professionals will play a major role in determining the future of health care in the United States. With leadership and foresight among the community of health professionals, our nation may yet achieve a system that allows the most honorable features of the healing professions to flourish."

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Comment: As we contemplate further deterioration in the most expensive but least efficient health care system in the modern world, there has never been a greater need to more thoroughly understand the fundamentals of health policy. Tom Bodenheimer and Kevin Grumbach, in this updated third edition of their classic text, provide a highly readable explanation of policy issues that must be understood by those who wish to help establish an equitable health care system for all of us. It is a great resource for those just learning about health policy. And for those that have more knowledge in the field, it is great for organizing thoughts and approaches to policy issues. It should be in the library of every health care reform activist.