Books to read on current American Healthcare System?

[ZorkDork1]

Hello!

Any suggestions on books to read that will shed greater light on the state of the American healthcare system? Preferably something written a little more recently to take into account all of the changes that has happened in the past several years.

Thanks!

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[Dr. Jan Itor]

I'm currently reading Reinventing American Health Care by Dr. Ezekiel Emanuel.


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[Lucca]

Understanding Health Policy: A clinical approach is a pretty standard recommendation as a primer for contemporary health policy. Easy to read, short, interesting.

 

[Traveler2016]

Definitely Reinventing American Healthcare. The Healing of America by TR Reid is also a really interesting read.

 

[Lawpy]

Understanding Health Policy: A clinical approach is a pretty standard recommendation as a primer for contemporary health policy. Easy to read, short, interesting.

Really great book as also recommended by @Med Ed @avgn and few others in recent conversations on this topic.

 

[jim.harbaugh]

I would highly recommend "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care" by T.R. Reid


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[redferrari]

Healthcare Handbook. Whichever is the newest edition.

 

[Efflorescence]

America's Bitter Pill by Steven Brill. It reads like a novel and I enjoyed it.

I'll second T.R. Reid's book. It doesn't discuss US healthcare very much, but it shows how other countries' healthcare systems function.

 

[theguardsman]

Second health care handbook

 

[vk77]

Would be a shame if you only read about American healthcare; in virtually every aspect, it's an exception, rather than a norm, for how "heath policy" is done around the world. Without understanding the fundamentals of health policy, I can't even imagine beginning to understand the basic nuances of the system in place in the US today.

 

[Cytarabine]

Avoid the opinion pieces until you lock down the objective stuff

 

[ZorkDork1]

Avoid the opinion pieces until you lock down the objective stuff

What do you mean?

 

[Cytarabine]

What do you mean?

Not sure how to say it better. You want to get through textbook style information before reading individual's opinions on what's happened and what needs to be changed so you have the context to interpret and weigh the substance of those opinions for yourself. Not to pick on any one in particular but because it's a good example, look at zeke's book - "Reinventing American Health Care: How the Affordable Care Act will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System"

It presents an argumentative thesis statement in the title. Starting there is like starting with atlas shrugged before macroecon 101 to learn economic theory (yes, this is hyperbole to drive my point)

 

[avgn]

Would be a shame if you only read about American healthcare; in virtually every aspect, it's an exception, rather than a norm, for how "heath policy" is done around the world. Without understanding the fundamentals of health policy, I can't even imagine beginning to understand the basic nuances of the system in place in the US today.

The best way to learn the basics of health policy in this country is to learn our nation's unique system. Why bother starting with England or Germany, you won't be exposed to all the goody ol' cornerstone American concepts like Medicaid federalism that are much more important to learn. It's just too confusing to start int'l; that should be reserved for advanced studies. Too big of a risk of disinterest the other way around. We don't need to lose more students like this

 

[avgn]

Hey OP I found you a gift 😏

http://forums.studentdoctor.net/thr...alth-and-policy-advice.1193073/#post-17641594

 

[vk77]

The best way to learn the basics of health policy in this country is to learn our nation's unique system. Why bother starting with England or Germany, you won't be exposed to all the goody ol' cornerstone American concepts like Medicaid federalism that are much more important to learn. It's just too confusing to start int'l; that should be reserved for advanced studies. Too big of a risk of disinterest the other way around. We don't need to lose more students like this

Ha! OP, this viewpoint is very naive. For you science-minded folks, this would be the logical equivalent of saying that we should study signal transduction pathways before understanding the utility of a membrane, running clinical efficacy trials on humans before testing drugs on model organisms like mice, or studying alkynes before alkenes in an organic chemistry class (just because they "seem" more interesting). Health policy (and especially US health policy) isn't some token field that you can cover in a one-hour session or book or an opinion piece. It's extremely nuanced topic -- in my opinion, orders of magnitude more complicated than a cell biology or a genetics course -- and a topic for that matter which is poorly understood by external stakeholders in healthcare (policymakers, too many physicians, the general public). A severe lack of interest and appreciation for health policy among so many physicians in particular, due to the structure of medical school curricula, is largely responsible for the monstrosity that is the American healthcare system right now, IMO.

If I were in your shoes, I would start off with a book on the fundamentals of health policy (if you're interested enough in the topic -- if not, that's totally fine), and I would just understand that (1) creating policy involves a lot of cultural, economic, and political contextualization (in other words, no singular type of health system is suitable for every community/state/country), (2) healthcare financing, payments, and structure resulting manifests as a continuum between completely privatized and completely public care (no country lies at either extreme), (3) healthcare systems, along this continuum, create different sets of "winners" and "losers," when considering who is paying into them and what they are getting, and (4) no country on the planet, despite what anyone will tell you these days, has "figured out" healthcare -- period.

Hopefully this helps! If you're studying this topic for the sake of medical school interviews, I'm sure that if you conveyed those 4 points to your interviewer, that's more than enough to demonstrate your understanding of health policy. I can't really imagine going into further depth on this topic in an interview, especially if your background is not in health policy. Your interview should focus on your interests, whatever they may be, after all.

 

[Dr. Jan Itor]

Not to pick on any one in particular but because it's a good example, look at zeke's book - "Reinventing American Health Care: How the Affordable Care Act will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System"

FWIW, the first half of the book is more of a history of American healthcare and explanation of how insurance works that is relatively unbiased.

I suggested it since it's a quick read and a bit easier to understand than some other more textbooky type books that claim to be intro level books but expect a certain level of background knowledge.


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[Onigiri]

Wow, this post was very helpful! Thank you for the inputs.

 

[Cytarabine]

FWIW, the first half of the book is more of a history of American healthcare and explanation of how insurance works that is relatively unbiased.

I suggested it since it's a quick read and a bit easier to understand than some other more textbooky type books that claim to be intro level books but expect a certain level of background knowledge.


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I haven't read his book so I can only comment with generality. Selective presentation of facts, presenting those facts cast in a certain light or with a certain tone, etc can all still forward an agenda (particularly effective strategy imo). Not to say a more textbook style book is necessarily immune from this

 

[avgn]

@vk77 I don't know what your background is but your logical equivalents aren't that logical. I agree with you on almost every single other point you brought up, especially the utility and utmost importance of the subject for physicians and the problem of disinterest among those in the profession, as well as your first bullet about contextual importance. But there is no reason one cannot learn the fundamentals well using the US as the case example. This is what Bodenheimer's book does and it works magnificently well. One can learn the basics of system financing, public/private insurance, fundamental economics, policy path dependence, and public policy history through examining the US. Again, international comparisons are better left for those interested enough to look there. They will gain much more at that stage. I didn't advocate for learning the US bc it's more interesting; by looking at other systems one misses a lot of the unique stuff in America that just isn't present elsewhere. I speak as someone whose background is fully in health policy with multiple years of post-college work experience.

 

[avgn]

FWIW, the first half of the book is more of a history of American healthcare and explanation of how insurance works that is relatively unbiased.

I haven't read his book so I can only comment with generality. Selective presentation of facts, presenting those facts cast in a certain light or with a certain tone, etc can all still forward an agenda (particularly effective strategy imo). Not to say a more textbook style book is necessarily immune from this

Not to get all philosophical, but effective history is by definition subjective and biased. The only completely objective histories would be those that are a listing of the facts, with no narrative or explanation. Hardly useful. If a theory exists in a standard telling of history, then it has a bias and the author is advancing his agenda. The question becomes not "how biased" a theory is (because they are all biased and how to judge which is more so?), but "does the narrative align with external political/social goals that the author is also advocating for."

In the case of Zeke, his writings typically end with his fervent advocating for recent Democratic work on health care. People will not all agree here.
In the case of Paul Starr, his writings typically end with a description of what is occurring recently, where it fits into his historical narrative, and how we can understand the forces better. People will also not all agree here.
Both are subjectively biased but differently so.

 

[Cytarabine]

Not to get all philosophical, but effective history is by definition subjective and biased. The only completely objective histories would be those that are a listing of the facts, with no narrative or explanation. Hardly useful. If a theory exists in a standard telling of history, then it has a bias and the author is advancing his agenda. The question becomes not "how biased" a theory is (because they are all biased and how to judge which is more so?), but "does the narrative align with external political/social goals that the author is also advocating for."

I don't disagree with the point being made, I think we're just operating with different scrupulousness in regard to defining bias. It's an important point to understand, but not one that ultimately changes the point I was trying to make (avoiding bias as defined in the last quoted sentence)