* The Next Generation of Healthcare Delivery. Michael A. Murer (Murer Consultants, Inc., Joliet, IL). Productivity Press, Oct 2014, 275p, $54.94hb As healthcare in the US continues to change, it is essential for all healthcare delivery entities to aggressively monitor the patterns of evolution in order to ensure high quality and cost-efficient healthcare delivery. Details implementation strategies to creatively respond to existing problems, issues, and obstacles in delivering effective healthcare; focuses on factual situations and case studies that demonstrate how healthcare delivery in the US must evolve to its next watershed period; examines the present status of healthcare delivery; and then discusses key concepts of change for various clinical, regulatory, financial, and political areas. More info at www.crcpress.com/9781439800744. (HEALTHCARE DELIVERY IN FUTURE)
* A Good Life in Old Age? Monitoring and Improving Quality in Long-term Care. Organisation for Economic Co-operation and Development and European Union. Paris: OECD, June 2013, 265p, $84pb and e-book. With the aging populations and growing costs, ensuring and improving the quality of long-term care (LTC) services has become an important policy priority across OECD countries. The share of those aged 80 years and over is expected to increase from 4% in 2010 to nearly 10% in 2050. In 2010 OECD countries allocated 1.6% of GDP to public spending on LTC, on average. The goal of good quality care is to maintain or, when feasible, to improve the functional and health outcomes of frail elderly, the chronically ill, and the physically disabled, whether they receive care in nursing homes, assisted living facilities, community-based or home care settings. Focuses on three aspects generally accepted as critical to quality care: 1) effectiveness and care safety, 2) patient-centeredness and responsiveness and 3) care co-ordination. Case studies feature Europe and the United States. (LONG-TERM CARE * AGING: OECD SURVEY)
* Universal Coverage of Long-Term Care in the United States: Can We Get There from Here? Edited by Douglas A. Wolf (Prof of Aging Studies, Syracuse U) and Nancy Folbre (Prof of Economics, U of Massachusetts, Amherst). NY: Russell Sage Foundation, Sept 2012, 243p, free download at russellsage.org. As millions of baby boomers retire and age in the coming years, more American families will confront difficult choices about the long-term care of their loved ones. The swelling ranks of the disabled and elderly who need such support—including home care, adult day care, or a nursing home stay—must often interact with a strained, inequitable and expensive system. The paid long-term care workforce is in crisis, due to increasing demand and a shortage of qualified workers. Assesses current US long-term care policies, the problems facing more comprehensive reform, and what can be learned from other countries facing similar care demands. Includes suggestions for moving policy toward a more affordable and universal system of long-term care insurance, based on recent reforms n other developed countries. (ELDER CARE * LONG-TERM CARE: UNIVERSAL COVERAGE)
* For Love and Money: Care Provision in the United States. Edited by Nancy Folbre (Prof of Economics, U of Massachusetts, Amherst). NY: Russell Sage Foundation, Aug 2012, 304p, $35pb. As women moved into the formal labor force in large numbers over the last 40 years, care work – traditionally provided primarily by women – has increasingly shifted from the family arena to the market. Child care, elder care, care for the disabled, and home care now account for a growing segment of low-wage work in the United States, and demand for such work will only increase as the baby boom generation ages. Explores why women continue to do most paid and unpaid care work, why care work is poorly paid when the quality of care is so highly valued, and how effective and equitable are public policies toward dependents in the US. Experts discuss theoretical dilemmas of care provision and provide an empirical overview of the looming problems for the US care sector. Key findings: 1) both love and money (i.e. family responsibility or limited job prospects) can be efficient motivators for caregiving; 2) job discrimination, social pressure, or personal motivation motivate women to specialize in care provision; 3) low-income families rely more on unpaid family members for their child and elder care than do affluent families; 4) problematic wages and working conditions, including high turnover, inadequate training and a “pay penalty” for workers who enter care jobs, results in poor job quality and care quality; 5) as for public policies that directly shape the provision of care for children or for adults who need personal assistance (such as family leave, child care tax credits and Medicaid-funded long-term care), income and variations in state policies are the greatest factors determining how well, and for whom, the current care system works. Calls for America to fundamentally rethink its care policies and increase public investment in this increasingly crucial sector. (CHILD CARE * ELDER CARE * CARE SYSTEM SCRUTINIZED)
** Contagion: How Commerce Has Spread Disease. Mark Harrison (prof and director, Wellcome Unit for the History of Medicine, U of Oxford). New Haven, CT: Yale U Press, Jan 2013, 400p, $38. Much as we take comfort in the belief that modern medicine and public health tactics can protect us from horrifying contagious diseases, such faith is dangerously unfounded. Harrison shows the intimate connections between trade and disease throughout modern history. For centuries commerce has been the single most important factor in spreading diseases to different parts of the world, and today the same is true. In today's global world, commodities and germs are circulating with unprecedented speed. Harrison examines the emergence of public health in the Western world, its subsequent development elsewhere, and a recurring pattern of misappropriated quarantines, embargoes, and other sanitary measures for political or economic gain—even for use as weapons of war. Today's public health regulations not only disrupt the global economy but also fail to protect the public from the afflictions of trade-borne disease. (PUBLIC HEALTH * DISEASE AND TRADE)
* The Longevity Seekers: Science, Business, and the Fountain of Youth. Ted Anton (Prof of English, DePaul U, Chicago). U of Chicago Press, May 2013, 224p, $26. For many centuries, people of searched for the fountain of youth. For a steadfast group of scientists, the secret to a long life lies in the lowly lab worm. By suppressing the function of just a few key genes, these scientists were able to lengthen worm lifespans up to tenfold, while also controlling the onset of many of the physical problems that beset old age. As the global population ages, the potential impact of this discovery on society is vast—as is the potential for profit. Anton has spent years interviewing and working with the scientists at the frontier of longevity science, and he offers a behind-the-scenes look at the state-of-the-art research and the impact it might have on global public health, society, our friends and family. (LONGEVITY SCIENCE * LIFESPAN EXTENSION)
* Chained to the Desk: A Guidebook for Workaholics, Their Partners and Children, and the Clinicians Who Treat Them (3rd Edition). Bryan E. Robinson (Prof Emeritus, U of North Carolina, Charlotte). NY: New York U Press, Feb 2014, 272p, $18.95pb. A psychotherapist in private practice and author of >35 books, such as Overdoing It: When Work Rules Your Life, notes that Americans love a hard worker. The worker who toils 18-hour days and eats meals on the run between appointments is usually viewed with a combination of respect and awe. For many, this lifestyle leads to family problems, a decline in work productivity, and ultimately to physical and mental collapse. Robinson provides an inside look at workaholism’s impact on those who live and work with work addicts—partners, spouses, children, and colleagues—as well as appropriate techniques for treatment. Originally published in 1998, the book was the first comprehensive portrait of the workaholic. The new edition draws on hundreds of case reports from Robinson's research and years of clinical practice. The agonies of workaholism have grown all the more challenging in a world where the computer, cell phone, and iPhone allow 24-hour access to the office, even on weekends and from vacation spots. (WORK AND HELATH * “WORKAHOLISM”)
* Pharmageddon. David Healy (Prof of Psychiatry, Cardiff U, UK; former Secretary, British Association for Psychopharmacology). Berkeley CA: U of California Press, March 2012, 302p, $39.95; reprinted in April 2013, $27.95pb. Healy's argument against “the pharmaceuticalization of medicine” tackles problems in health care that are leading to a growing number of deaths and disabilities: “over 80% of the reports on the adverse consequence of treatment, dismissed as anecdotes, have turned out to be correct.” (p.252) Healy, who was the first to draw attention to the now well-publicized suicide-inducing side effects of many anti-depressants, attributes our current state of affairs to three key factors: 1) product rather than process patents on drugs, 2) the classification of certain drugs as prescription-only, and 3) industry-controlled drug trials. These developments have tied the survival of pharmaceutical companies to the development of blockbuster drugs, so that they must overhype benefits and deny real hazards. Explains why these trends have basically ended the possibility of universal health care in the United States and elsewhere around the world. Concludes with suggestions to reform our “currently corrupted evidence-based medical system.,” such as www.RxISK.org, a free, independent drug safety website launched in Oct 2012. (HEALTH AND DRUG INDUSTRY * MEDICINE “PHARMACEUTICALIZED”)
* Health and Human Rights: Basic International Documents (Third Edition). Edited by Stephen P. Marks (Prof of Health and Human Rights; Director, Dept of Global Health and Population, Harvard School of Public Health). Cambridge MA: FXB Center for Health and Human Health (dist by Harvard UP), Feb 2013, 568p, $28.95. This edition has been updated and expanded to provide the practitioner, scholar, and advocate with access to the most basic instruments of international law and policy that express the values of human rights for advancing health. Topics include professional ethics; research and experimentation; bioethics and biotechnology; the right to health; the right to life; freedom from torture; war crimes; crimes against humanity and genocide; the right to an adequate standard of living; women and reproductive health; children; persons with disabilities; the rights of other vulnerable groups; infectious diseases; business, trade, and intellectual property; non-communicable diseases; the right to a clean environment; and sustainable development. [Note: Beginning with Volume 15, HUP will become the publisher of Health and Human Rights: An International Journal (www.hhrjournal.org) founded in 1994 by Jonathan Mann and now edited by Paul Farmer, Chair of the Dept of Global Health at Harvard Medical School. Also see Reimagining Global Health: An Introduction (U of California Press, Aug 2013, 436p, $34.95pb), edited by Paul Farmer et al.] (HUMAN RIGHTS AND HEALTH)
* Me Medicine vs. We Medicine: Reclaiming Biotechnology for the Common Good. Donna Dickenson (Prof Emerita of Medical Ethics, U of London; research associate, Centre for Health, Law, and Emerging Technologies, U of Oxford). NY: Columbia U Press, June 2013, 304p, $29.95. Personalized medicine – Me Medicine-- illustrates capitalism's flexible talent for creating new products and markets where none existed before and has been triggered by 1) a growing sense of threat in our society; 2) a wave of patient narcissism; 3) corporate interests in creating new niche markets; and 4) the dominance of personal choice as a cultural value. Historically, it is the measures of "We Medicine," such as vaccination, that have radically extended our life spans. We've lost sight of that truth in our enthusiasm for "Me Medicine." Personalized healthcare is radically transforming our longstanding, "one-size-fits-all" model. Technologies such as direct-to-consumer genetic testing, pharmacogenetics in cancer care, private umbilical cord blood banking, and neurocognitive enhancement claim to cater to an individual's specific biological character. Dickenson examines the economic and political factors fueling the “Me Medicine” phenomenon and explores whether it may, over time, damage our individual health as well as our collective well-being. (PERSONALIZED MEDICINE * HEALTH AND SOCIETY * "ME MEDICINE" VS "WE MEDICINE" * BIOTECHNOLOGY)
* One Nation Under Stress: The Trouble with Stress as an Idea. Dana Becker (Prof of Social Work, Bryn Mawr College). NY: Oxford U Press, March 2013, 256p, $35. Americans ignore the underlying social and political conditions that create stress. Our national infatuation with the therapeutic culture has created a middle-class moral imperative to manage the tensions of daily life by turning inward, ignoring the social and political realities that underlie those tensions. Although stress is often associated with conditions over which people have little control, the stress concept focuses most of our attention on how individuals react to stress. A proliferation of self-help books and dire medical warnings about the negative effects of stress on our physical and emotional health all place the responsibility for alleviating stress--though yoga, deep breathing, better diet, etc.--squarely on the individual. The stress concept has come of age in a period of tectonic social and political shifts; we persist in the all-American belief that we can meet these changes by re-engineering ourselves rather than tackling the root causes of stress. (STRESS RECONSIDERED * HEALTH* SOCIETY)
*Knowledge Networks and Markets in the Life Sciences. OECD. Paris: Organisation for Economic Co-operation and Development, May 2012, 100p. Introduces the concept of “knowledge networks and markets” (KNMs), arguing that creation of such exchange mechanisms is an important new trend in the life sciences, particularly in the health sector, “with potentially profound influence on the innovation process.” In the last five years, there has been “an explosion” of initiatives in the life sciences to bring together dispersed and diverse elements of the research infrastructure and simplify the learning process. Topics include the changing “knowledge complex” in the biosciences, the functioning of KNMs, benefits of KNMs (accelerating health innovation, reducing risks and costs of R&D, reducing health-care expenditures), how infotech informs the design of knowledge networks, case studies of KNMs currently in use, future trends in valuation of biotechnology and pharmaceutical assets (and the companies that hold them), and the support that KNMs currently enjoy from government. (HEALTH * METHODS * KNOWLEDGE NETWORKS * SCIENCE/TECHNOLOGY)
* Vaccine: The Debate in Modern America. Mark A. Largent (Assoc Prof of History and Director, Science, Technology, Environment, and Public Policy Program, Michigan State U). Baltimore MD: Johns Hopkins U Press, Sept 2012, 240p, $34.95 (also as e-book). Since 1990, the number of mandated vaccines has increased dramatically—nearly three dozen vaccinations by age six—but parents worry about the unintended side effects. “Nearly 40 % of American parents report that they delay or refuse a recommended vaccine for their children.” Despite assurances from every mainstream scientific and medical institution, parents continue to be haunted by the question of whether vaccines cause autism. In response, health officials herald vaccines as both safe and vital to the public’s health, and put programs and regulations in place to encourage parents to follow the recommended vaccine schedule. The vaccine-autism debate obscures a constellation of concerns held by many parents, including anxiety about the number of vaccines required (some for diseases that children are unlikely ever to encounter); unhappiness about the rigorous schedule of vaccines during well-baby visits; and fear of potential side effects, some of them serious or even life-threatening. Largent disentangles competing claims, opens the controversy for critical reflection, and provides recommendations for moving forward. (HEALTH * VACCINATION DEBATE * CHILDREN)
* The Silent Epidemic: Coal and the Hidden Threat to Health. Alan H. Lockwood, M.D. (Emeritus prof of Neurology, SUNY at Buffalo). Cambridge MA: MIT Press, Sept 2012, 248p, $24.95. The lead author of a Physicians for Social Responsibility report on the adverse effects of coal notes that almost half of the energy used to generate electricity comes from burning coal. “Coal-fired plants make people sick and die, particularly children and those with chronic illnesses, and they cost society huge amounts of money desperately needed for other purposes.” As politicians and advertising campaigns extol the virtues of “clean coal,” the dirty secret is that coal kills: tens of thousands of deaths from asthma, chronic obstructive pulmonary disease, lung cancer, heart attacks, strokes, and other illnesses are clearly linked to coal-derived pollution. Coal mining, transporting, burning, and disposal generate significant health concerns as coal pollution impacts the respiratory, cardiovascular, and nervous systems. (HEALTH * ENERGY * COAL POLLUTION)
* The Global Organ Shortage: Economic Causes, Human Consequences, Policy Responses. T. Randolph Beard (Prof of Economics, Auburn U), David L. Kaserman (deceased in 2008, former Prof of Economics, Auburn U), and Rigmar Osterkamp (Senior Economist, Ifo Institute for Economic Research; Research Coordinator in Economics, U of Namibia). Palo Alto CA: Stanford U Press, Dec 2012, 264p, $60. Although organ transplants provide the best, and often the only, effective therapy for many otherwise fatal conditions, the great benefits of transplantation go largely unrealized because of failures in the organ acquisition process. In the US, for instance, more than 10,000 people die every year either awaiting transplantation, or as a result of deteriorating health exacerbated by the shortage of organs. Issues pertaining to organ donation and transplantation represent perhaps the most complex and morally controversial medical dilemmas aside from abortion and euthanasia. These quandaries are not unsolvable: organ donors should be compensated within a publicly controlled monopsony, similar to current practices in Spain, where organ donors are compensated. The authors discuss the medical history of transplantation, development of national laws and waiting lists, the social costs and benefits of transplantation, the causes of organ shortages, "partial" reforms tried or proposed, and the ethics of the current system and its competitors. (HEALTH * ORGAN DONATION)
* Phake: The Deadly World of Falsified and Substandard Medicines. Roger Bate (Fellow in Global Prosperity, American Enterprise Institute). Washington: AEI Press (dist. by Rowman & Littlefield), May 2012, 400p, $49.95. Draws on many years spent on the trail of counterfeit medicines in Asia, Africa, and the Middle East to expose the anatomy of a nebulous, far-reaching black market that has resulted in countless deaths and injuries around the world. Describes the counterfeit drug trade and offers an incisive policy analysis with important ramifications for decision makers in the U.S. Food and Drug Administration and the World Health Organization. (HEALTH * CRIME * DRUG COUNTERFEITING * COUNTERFEIT DRUG TRADE)
* The Epigenetics Revolution: How Modern Biology Is Rewriting Our Understanding of Genetics, Disease, and Inheritance. Nessa Carey (former Senior Lecturer, Imperial College in London). NY: Columbia U Press, March 2012, 352p, $26.95. Epigenetics has the potential to revolutionize our understanding of the structure and behavior of biological life on earth. It explains why mapping an organism’s DNA code is not enough to determine how it develops or acts, and shows how nurture combines with nature to engineer biological diversity. Epigenetics is now informing our understanding of drug addiction, cancer, malnutrition, mental disorders such as schizophrenia, and the physical and psychological consequences of childhood trauma. Offers future directions of research and the potential for epigenetics to improve human health and well-being. (SCIENCE * EPIGENETICS * BIOLOGY AND EPIGENETICS * HEALTH)
* From Public Health to Wellbeing: The New Driver for Policy and Action. Edited by Paul Walker and Marie John (Lecturers, Division of Integrated Health/Social Care, Dept of Care Sciences, U of Glamorgan, UK). NY & UK: Palgrave Macmillan, Jan 2012, 224 pages, $35pb. Charting the history and evolution of the public health agenda, this reader argues for the place of wellbeing in local and national strategy. Explores current thinking and policy within a range of settings, such as the NHS, the workplace, and the community. Chapters focus on: public health and wellbeing; wellbeing meaning, definition, measurement and application; wellbeing as guiding concept for health policy; wellbeing and spatial planning; wellbeing and children/young people; wellbeing and older people; wellbeing and work; the well being framework applied to drug policy, and wellbeing and community action. (HEALTH * PUBLIC HEALTH * WELL-BEING/HAPPINESS * HAPPINESS/WELL-BEING)
* Well-Being: Individual, Community and Social Perspectives. Edited by John Haworth (Research Fellow, Research Institute for Health and Social Change Manchester Metropolitan U) and Graham Hart (Director, Center for Sexual Health & HIV Research, Royal Free & U College Medical School, London). NY & UK: Palgrave Macmillan, Jan 2012, 296 pages, $32pb. Addresses well-being from individual, community, and social perspectives in an integrated manner and complements the harm-based focus of much social scientific research into health. Chapters by a wide range of academics present a new dynamic view of well-being for the 21C and focus on positive psychology and the development of well-being; health, well-being and social capital; a life course approach to well-being; politics and well-being; whether well-being is local or global; interdependence of personal and communal well-being; societal inequality, health and well-being. (SOCIETY * HEALTH * HAPPINESS/WELL-BEING * WELL-BEING PERSPECTIVES)
* Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. Committee on Advancing Pain Research, Care, and Education; Institute of Medicine. Washington: National Academies Press: Jan 2012, 382p, $59.95. Chronic pain affects at least 116 million American adults—more than the total affected by heart disease, cancer, and diabetes combined. “It costs the nation up to $635 billion each year in medical treatment and lost productivity.” Pain varies from person to person, and providers should tailor pain care to each patient’s experience, while promoting self-management of pain. A cultural transformation in the way clinicians and the public view pain and its treatment is necessary to better prevent, assess, treat, and understand pain of all types. The National Center for Health Statistics, the Agency for Healthcare Research and Quality, other government agencies, and private organizations should accelerate the collection of data on pain incidence, prevalence, and treatments. Successful prevention, treatment, and management of pain requires an integrated approach that responds to all factors that influence pain. (HEALTH * PAIN TREATMENT & PREVENTION)
* The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. Eric Topol, M.D. (Prof of Innovative Medicine, Scripps Translational Science Institute, La Jolla CA). NY: Basic Books, Feb 2012, $27.99. Many new medicines, although tested with seemingly large trials, reveal most of their problems only when they are out in the real world, with millions of people with all kinds of conditions mixing them with everything in the pharmacopeia. The unexpected interactions of drugs, patients, and diseases can be devastating and costly. To avoid these dangerous interactions, Topol argues for bringing the era of big data to the clinic, laboratory, and hospital, with wearable sensors, smartphone apps, and whole-genome scans. Combining all the data these tools can provide will give us a complete and continuously updated picture of every patient, changing the treatment of disease, development of new treatments, and prolonging of health. Also discusses at-home brain monitors to improve sleep, sensors to track all vital signs, improved imaging techniques, using genetics to show who might be helped or hurt by a drug, and the latest printing technology enabling creation of new organs rather than looking for donors. (HEALTH * TECHNOLOGY AND HEALTH * MEDICINE AND INFOTECH)
* Health Reform: Meeting the Challenge of Ageing and Multiple Morbidities. Organisation for Economic Co-operation and Development. Paris: OECD, Nov 2011, 221p. “The ageing of our societies is at the same time one of our greatest achievements and one of our biggest challenges.” The professional organization of health provision no longer reflects the changing patient and population health needs caused by the growing number of complex illnesses. In 1961, when the OECD was founded, health systems were gearing themselves up to deliver acute care interventions. Sick people were to be cured in hospitals, then sent on their way again. Medical training was focused on hospitals; innovation was to develop new interventions; payment systems were centered around single episodes of care. Health systems have delivered big improvements in health since then, but they can be slow to adapt to new challenges. In particular, these days, the overwhelming burden of disease is chronic, for which ‘cure’ is out of our reach. Health policies have changed to some extent in response, though perhaps not enough. But the challenge of the future is that the typical recipient of health care will be aged and will have multiple morbidities. Examines how payment systems, innovation policies, and human resource policies need to be modernized so that OECD health systems will continue to generate improved health outcomes in the future at a sustainable cost. Today’s health care is at a crossroads in thinking about financing care for older people with multiple morbidites and multiple needs, with a choice of two paths: 1) one path leads to detailed care plans, bundling payments, transferring risk, and traditional market competition; 2) the other path leads to whole system targets with minimum specification, pooled budgets, and innovative market models. “Demographic and epidemiological realities will force governments to choose, and they need to think carefully about which direction to go.”
(HEALTH SYSTEMS REFORM * GOVERNMENT AND HEALTH)
* Remedy and Reaction: The Peculiar American Struggle over Health Care Reform. Paul Starr (Prof of Sociology and Public Affairs, Princeton U). New Haven, CT: Yale U Press, Oct 2011, 320p, $28.50. America has endured a century of rancorous debate on health insurance, and, despite passage of legislation in 2010, the battle is not over. The US has ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change. Explains how Mitt Romney’s reforms in Massachusetts became the model for Democrats, and the explosive reaction that reforms under Obama elicited from conservatives. (HEALTH * HEALTHCARE)
* The Quest for Mental Health: A Tale of Science, Medicine, Scandal, Sorrow, and Mass Society. Ian Dowbiggin (Prof of History, U of Prince Edward Island, Canada). NY: Cambridge U Press, Aug 2011, 264p, $24.99pb. The quest for emotional wellbeing has reached a crisis point because mass society has been enveloped by cultures of therapism and consumerism. An enormous industry of psychiatrists, psychologists, counselors, therapists, social workers, and life coaches have invaded our lives, furthering our dependence on psychological sciences to ease the troubles of everyday life. Such a dependence, though, has only encouraged bureaucratic and managerial approaches to health and welfare. And reported rates of depression and anxiety are skyrocketing. Without systemic changes, “the quest for mental health is likely to make us more miserable rather than more happy.”
(HEALTH * MENTAL HEALTH * SOCIETY AND WELLBEING)
* The Vegetarian Imperative. Anand M. Saxena (biophysicist, Brookhaven National Laboratory). Baltimore MD: Johns Hopkins U Press, Oct 2011, 240p, $24.95. The burgeoning population and increasing preference for meat in all parts of the world are stretching planetary resources beyond their limits, while the huge livestock industry is degrading the agricultural land and polluting air and water. Also, out appetite for animal-based foods contributes directly to high rates of chronic diseases. Recommends a much-needed shift to a diet of properly chosen plant-based foods.
(HEALTH * SUSTAINABILITY * VEGETARIAN IMPERATIVE)
* Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America (Third Edition). Donald A. Barr (Assoc Prof of Pediatrics, Stanford U). Baltimore MD: Johns Hopkins U Press, Dec 2011, 384p (7x10”), $50pb. American health care is the best medical care system in the world; on the other hand, it is the worst among developed countries because of how it is organized. The recent passage of the Affordable Care Act, rather than quelling the rhetoric, has sparked even more debate. Topics include insurance, Medicare and Medicaid, the shift to for-profit managed care, the pharmaceutical industry, issues of long-term care, the plight of the uninsured, medical errors, and nursing shortages. This updated edition describes and discusses key sectors of America’s health care system in light of the affordable Care Act.
(HEALTH POLICY OVERVIEW * AFFORDABLE CARE ACT)
* Health Care Comes Home: The Human Factors. National Research Council. Washington: National Academies Press, Sept 2011, 200p, $32pb. In the US, health care devices, technologies, and practices are rapidly moving into the home due to the costs of health care, the growing number of older adults, the increasing prevalence of chronic conditions and diseases, improved survival rates for people with those conditions and diseases, and a wide range of technical innovations. The health care that results differs considerably in its safety, effectiveness, and efficiency, as well as in quality and cost. There are design problems and imbalances between technological system demands and the capabilities of users. Recommendations cover 1) regulation of health care technologies, 2) proper training and preparation for people who provide in-home care, and 3) modification of existing housing into better residential health care. (Also see The Future of Nursing: Leading Change, Advancing Health, NAP, 2010, 620p, $49.95.) (HEALTH * SCIENCE/TECHNOLOGY)
** War on Drugs: Report of the Global Commission on Drug Policy. Fernando Henrique Cardoso (Chair; former President of Brazil), George P. Schultz (Honorary Chair, former US Secretary of State), and 17 others. Global Commission, June 2011, 24p (download at www.globalcommissionondrugs.org). “The global war on drugs has failed, with devastating consequences for individuals and societies around the world.” Fifty years after initiating the UN Single Convention on Narcotic Drugs, and 40 years after President Nixon launched the US war on drugs, “fundamental reforms in national and global drug control policies are urgently needed.” Vast expenditures on criminalization and repressive measures directed at producers, traffickers, and consumers of illegal drugs have clearly failed to curtail supply or consumption. Apparent victories in eliminating one source or trafficking organization are negated almost instantly by emergence of other sources and traffickers. Repressive efforts directed at consumers impede public health measures. Government spending on futile supply reduction strategies and incarceration displace more cost-effective and evidence-based investments. Principles and proposals: 1) end the criminalization and stigmatization of people who use drugs, but who do no harm to others; 2) encourage experimentation by governments with models of legal regulation of drugs to undermine the power of organized crime and safeguard the health and security of citizens (this applies especially to cannabis); 3) offer health and treatment services to those in need, ensuring that a variety of treatment modalities are available; 4) respect the human rights of people who use drugs and abolish abusive practices carried out in the name of treatment; 5) apply much the same principles and policies stated above to people involved in the lower ends of illegal drug markets (e.g. farmers, couriers, petty sellers); incarcerating tens of millions of these people in recent decades has filled prisons and destroyed lives and families; 6) invest in activities that can prevent young people from taking drugs and prevent those who do use drugs from developing more serious problems (eschew simplistic “just say no” messages and “zero tolerance” policies); 7) focus repressive actions on violent criminal organizations in ways that undermine their power and reach; 8) begin the transformation of the global drug prohibition regime with fiscally responsible policies and strategies grounded in science, health, security, and human rights; 9) “break the taboo on debate and reform: the time for action is now.” [NOTE: Other members of the Commission include Kofi Annan (former UN Secretary-General) and former Presidents of Colombia and Mexico.] (DRUGS: GLOBAL COMMISSION * SECURITY * HEALTH * PUBLIC HEALTH * CRIME HUMAN RIGHTS)
* Patterns of Potential Human Progress, Volume 3: Improving Global Health—Forecasting the Next 50 Years. Barry B. Hughes (Prof of Pol Sci and Director, Pardee Center for International Futures, U of Denver) and four others. Boulder CO: Paradigm Publishers, Jan 2011, 352p (8x11”), $49.95pb. (Free PDF download at www.ifs.du.edu). Uses the International Futures (IFs) simulation model to explore prospects for human development that appear to be unfolding globally and locally, how we would like it to evolve, and how better to move in desired directions. Volume 1 explored prospects for reducing global poverty and Volume 2 considered education [see Pardee Center in GFB index]. This volume focuses on possible futures for the health of peoples, health outcomes we might expect given current patterns of development, opportunities for intervention and achieving alternative health futures, and how improved health futures might affect broader prospects of countries, regions, and the world. Topics include measuring the disease burden, drivers of health, proximate risk factors (undernutrition, obesity, tobacco use), environmental risk factors (sanitation, air pollution, climate change), and integrated scenario analysis. (WORLD FUTURES * PARDEE
CENTER * INTERNATIONAL FUTURES MODEL * HEALTH: GLOBAL OVERVIEW * DEVELOPMENT)
** Phantom Billing, Fake Prescriptions, and the High Cost of Medicine: Health Care Fraud and What to Do About It. Terry L. Leap (Prof of Management, Clemson U). Ithaca NY: Cornell U Press/ILR Press, April 2011, 256p, $29.95. US health care is a $ 2.5 trillion system that accounts for more than 17% of the nation’s GDP. It is also highly susceptible to fraud. Some observers believe that as much as 10% of medical billing involves some type of fraud. Looks at a wide variety of crimes (kickbacks, illicit referrals, overcharging and double billing, upcoding, unbundling, rent-a-patient and pill-mill schemes, insurance scams, short-pilling, off-label marketing of pharmaceuticals, and rebate fraud), as well as criminal acts that enable this fraud (mail and wire fraud, conspiracy, and money laundering). Suggests ways that providers, consumers, insurers, and federal and state officials can bring health care fraud and abuse under control. (HEALTH * CRIME/JUSTICE * HEALTH CARE FRAUD)
* The World Health Report: Health Systems Financing — The Path to Universal Coverage. World Health Organization. Geneva: World Health Organization (dist by Stylus), Dec 2010, 140p, $40. Protection and promotion of health is essential to human welfare, to sustained economic and social welfare, and to sustained economic and social development. WHO’s Member States have set the target of developing their health financing systems to ensure that all people can use health services, while being protected against financial hardship associated with paying for them. The report maps out what countries can do to modify their financing systems to move towards universal coverage and provides an agenda for countries at all stages of development. (HEALTH * HEALTH SYSTEM
FINANCE WORLDWIDE * WORLD HEALTH REPORT (WHO) * UNIVERSAL HEALTH COVERAGE)
* Economic Aspects of Obesity. Edited by Michael Grossman (Distinguished Prof of Economics, Graduate Center, CUNY) and Naci Mocan (Distinguished Chair of Economics, Louisiana State U). National Bureau of Economic Research (dist by U of Chicago Press), May 2011, 456p, $110. In the past three decades, the number of obese adults in the US has doubled and the number of obese children has almost tripled, which may lead to increased medical expenditures, productivity loss, and stress on the health care system. Weight gain is the result of individual choices in response to economic environments. Incentives – food prices, availability of food outlets and recreational facilities, health insurance, minimum wage levels – can influence individual behaviors affecting weight. Evaluates costs and benefits of various proposals designed to control obesity rates.
(HEALTH * OBESITY AND ECONOMIC INCENTIVES)
** Sickness, Disability and Work: Breaking the Barriers. A Synthesis of Findings across OECD Countries. Organization for Economic Co-operation and Development. Paris: OECD, Oct 2010, 105p, free pdf at www.oecd-ilibrary.org. Too many workers leave the labor market permanently due to health problems or disability, and too few people with reduced work capacity remain in employment. This social and economic tragedy is common to nearly all OECD countries. Average health status is improving in OECD countries, yet large numbers of people of working age are leaving the workforce to rely on long-term sickness and disability benefits. The report explores possible factors behind this paradox. A series of major reforms are needed to promote employment of people with health problems, and better incentives for the main actors – workers, employers, doctors, public agencies, and service providers – are crucial. The report also examines policy choices: tightening inflows vs. raising outflows from disability benefit, and promoting job retention vs. new hiring of people with health problems. Questions the need for distinguishing unemployment and disability as two distinctive contingencies, emphasizes the need for a better evidence-base, and underlines challenges for policy implementation. (WORK AND DISABILITY * DISABILITY AND WORK * HEALTH AND WORK)
* Improving Health Sector Efficiency: The Role of Information and Communication Technologies. Organisation for Economic Co-operation and Development. Paris: OECD, June 2010, 156p, free pdf. Implementing information and communication technologies (ICTs) in clinical care has proven to be a very difficult undertaking: a decade of significant public investments resulted in both successes and highly publicized costly delays and failures. The general public and the medical profession have failed to reach a consensus on the benefits of electronic record keeping and information exchange. Uses lessons from case studies in Australia, Canada, the Netherlands, Spain, Sweden, and the US to identify opportunities offered by ICTs, and to analyze under what conditions these technologies are most likely to result in efficiency and quality-of-care improvements.
(HEALTH SECTOR EFFICIENCY * INFOTECH AND HEALTHCARE)
* Health Care Systems: Efficiency and Policy Settings. Organisation for Economic Co-operation and Development. Paris: OECD Publishing, Nov 2010, 207p, PDF and print. An in-depth look at health care in OECD countries: the status of people’s health, how to measure health outcomes and the efficacy of health care systems, how health policies are linked with performance of health care systems, trends in health care outcomes and spending (public health care spending in the OECD areas is projected to increase by 3.5% to 6% of GDP by 2050), and how to systematically improve the health status of populations in a cost-effective manner. International comparisons allow spotting of strengths and weaknesses for each country, and policy reforms which could yield efficiency gains.
(HEALTH * HEALTH CARE SYSTEMS: OECD)
* Obesity and the Economics of Prevention: Fit not Fat. Organisation for Economic Co-Operation and Development. Paris: OECD Publishing, Sept 2010, 268p, free pdf. Before 1980, rates were generally well below 10%, but now 50% or more of the population in OECD countries is overweight, due to an imbalance of calories taken in and calories burned. A key factor for numerous chronic diseases, “obesity is a major public health concern.” This analysis by OECD, partly in cooperation with the World Health Organization, explores multiple dimensions of the obesity problem: the scale and characteristics of the epidemic, the respective roles and influences of market forces and governments, and the impact of interventions (“little has been effective in slowing the upward trend”). Topics include the economics of prevention, impact on the economy, future trends, social dimensions, child obesity, community interventions, regulation of food advertising to children, etc. “A comprehensive strategy is needed to prevent and control obesity,” involving a multi-stakeholder approach. Co-operation between governments and the food industry is the single most critical link.
(HEALTH * PUBLIC HEALTH * OBESITY EPIDEMIC: OECD)
* Medical Professionalism in the New Information Age. Edited by David J. Rothman (Prof of Social Medicine, Columbia College of Physicians & Surgeons) and David Blumenthal (national coordinator for health information technology, Dept. of Health and Human Services). Piscataway NJ: Rutgers U Press, Sept 2010, 224p, $24.95pb. While computerized health information is receiving unprecedented government support, the intricate legal, social, and professional implications of the new technology need further scrutiny. Explores how health information technology (HIT) may alter relationship between physicians and patients, undermine physicians’ traditional information monopoly, increase physician legal liability, and heighten expectations about transparency. An independent HIT profession may emerge, bringing another organized interest into the medical arena.
(INFOTECH AND HEALTH * HEALTH AND INFOTECH)
* The Future of Nursing: Leading Change, Advancing Health. Institute of Medicine. Washington: National Academies Press, 2010/620p/$49.95 (free PDF at www.nap.edu). Report of the Robert Wood Johnson Foundation Initiative on the Future of Nursing, exploring how the roles, responsibilities, and education of nurses should change significantly to meet increased demand for care in America’s increasingly complex health system. Nurses, numbering >3 million, make up the largest single segment of the health care work force, and spend the greatest amount of time delivering patient care. They should assume leadership roles in redesigning care in the US, and encourage further education (e.g., 80% with a bachelor’s degree by 2020). Regulatory and institutional obstacles that limit the scope of practice should be removed. Chapters and appendices focus on transforming education and leadership, meeting the need for better data, matching nursing practice to future needs, transformational models of nursing across different care settings, and international models of nursing.
(HEALTH * NURSING REFORM)
* Digital Medicine: Health Care in the Internet Era (Revised Edition). Darrell M. West (VP and Director, Governance Studies, Brookings Inst) and Edward Alan Miller (Assoc Prof of Gerontology and Public Policy, U of Massachusetts-Boston). Washington, DC: Brookings Institution Press, March 2010, 185p, $22.95pb. Consumers can access a great amount of medical information online and health care products can be purchased electronically. Political, social, and ethical challenges presented by online health care are explored. Evaluates the accessibility of health-related websites for different populations and discusses how to close access gaps and ensure reliability and trustworthiness of online info.
(DIGITAL MEDICINE * HEALTH INFO ONLINE* INTERNET AND HEALTH CARE)
* Forced to Care: Coercion and Caregiving in America. Evelyn Nakano Glenn (Prof of Women’s and Ethnic Studies, U of California-Berkeley). Cambridge MA: Harvard U Press, June 2010, 280p, $29.95. The US faces a growing crisis in care, as the number of people needing care grows, while the ranks of traditional caregivers shrinks. Explains the devaluation of care work and exclusion of both unpaid and paid care workers from critical rights such as minimum wage, retirement benefits, and worker’s comp. Women—especially immigrants and women of color—perform a disproportionate share of caring labor. Proposes strategies for improving the situation of unpaid family caregivers and paid home healthcare workers. (WORK * CAREWORKER CRISIS * HEALTH: CAREGIVING)
* Health at a Glance: OECD Indicators. Organisation for Economic Co-operation and Development. OECD, Sept 2009/200p/$35pb (dist. by Brookings). Annual providing data and trends on the performance of health systems in OECD countries, showing variations across countries in health status and risks, inputs and outputs of health systems, and data on the long-term care workforce.
(HEALTH: OECD COMPARISON * INDICATORS: HEALTH)
* Achieving Better Value for Money in Health Care. OECD Health Policy Studies. Organisation for Economic Co-operation and Development, Nov 2009/167p. Rising health care spending is a problem in nearly all countries, leading to interest in improving health system performance. This report examines policy instruments such as competition in health markets, the scope for improving care coordination, better pharmaceutical pricing policies, increased cost sharing, and greater quality control supported by stronger information and communication technology.
(HEALTH * HEALTH SYSTEM PERFORMANCE/OECD)
** Taming the Beloved Beast: How Medical Technology Costs Are Destroying Our Health Care System. Daniel Callahan (President Emeritus, Hastings Center). Princeton UP, Oct 2009/288p/$29.95. A leading medical ethicist argues that medtech saves lives and relieves suffering, yet its costs are rising at a dangerously unsustainable rate, posing a deep ethical and policy dilemma about limiting use; reining in health care costs will require change in entrenched values about progress and technological innovation, and only a government-regulated universal system can offer hope of managing technology and making it affordable for all. (HEALTH CARE * MEDICAL TECHNOLOGY)
* Pharmacogenetics: Opportunities and Challenges for Health Innovation. OECD Innovation Strategy. Organisation for Economic Co-operation and Development, Nov 2009/135p. On how to optimize the use of pharmacogenetics—the relationship between an individual’s genetic makeup and the way medicines work for each person—to deliver effective innovations for public health, and design policies that enhance their social and economic benefits. Proposals are made for governments (large-scale studies to measure impacts), health systems (steps to enhance usage and ensure adequate training), and regulatory authorities.
(HEALTH * PHARMACOGENETICS * GENETICS AND MEDICINES * SCI/TECH)
* Digital Medicine: Health Care in the Internet Era. Darrell M. West (VP and director of Governance Studies, Brookings) and Edward Alan Miller (Asst Prof of Public Policy, Brown U). Washington: Brookings Institution Press, April 2009/192p/$34.95. Infotech is being used in health care in many ways, yet the promise of “e-health” remains largely unfulfilled; the authors look at factors limiting the ability of IT to remake health care in the US and worldwide, the social and ethical challenges of online health care, and the ways in which officials in other countries have implemented health IT. (HEALTH * INFOTECH)
* Global Pharmaceutical Policy: Ensuring Medicines for Tomorrow’s World. Frederick M. Abbott (College of Law, Florida State U) and Graham Dukes (U of Oslo). Northampton MA: Edward Elgar, Oct 2009/320p/$135. Describes laws, policies, and customs relating to development and provision of medicines, identifies their strengths and weaknesses, and proposes global solutions for getting appropriate and affordable medicines, received in a timely way.
(HEALTH * PHARMACEUTICAL POLICY WORLDWIDE)
* The State of the World’s Children 2009: Maternal and Newborn Health. UN Children’s Fund (UNICEF). NY: United Nations Publications, 2009/164p/$25 (sales #E.09.XX.1). Explores the fundamentals of a supportive environment for mothers and newborns, and outlines ways to strengthen efforts supporting primary health care. Also offers general indicators of child well-being.
(CHILDREN * HEALTH)
* Healing the Broken Mind: Transforming America’s Failed Mental Health System. Timothy A. Kelly (Director, Public Policy Institute, Fuller Graduate School of Psychology, Pasadena CA). New York U Press, Aug 2009/208p/$25.95. Former Commissioner of Virginia’s Dept of Mental Health points to recent progress in understanding and treating mental illness, yet many people across the US who struggle with serious problems are unable to find effective, quality treatment. The patchwork of care employed to treat mental illness needs replacement by fundamental, system-wide change enabling patients to achieve a lasting recovery. (HEALTH * MENTAL HEALTH)
* Rising Plague: The Global Threat from Deadly Bacteria and Our Dwindling Arsenal to Fight Them. Brad Spellberg, M.D. (Assoc Prof of Medicine, UCLA). Amherst NY: Prometheus Books, Sept 2009/250p/$26. Antibiotic-resistant microbes infect >2 million Americans and kill >100,000 each year. Worldwide, many more people are dying from these rapidly spreading infections. At the same time, R&D of new antibiotics has ground to a halt. Warns against complacency that some miracle drug will always be available; if we do nothing, we risk a bleak future when infectious diseases will once again reign supreme. Physician misuse of antibiotics and “dirty hospitals” are not the cause of this potentially grave public health crisis. (HEALTH * PUBLIC HEALTH * ANTIBIOTIC-RESISTANT MICROBES)
** Green Intelligence: Creating Environments That Protect Human Health. John Wargo (Prof of Environmental Policy and Pol Sci, Yale U). Yale U Press, Sept 2009/400p/$32.50. We live in a world awash in manmade chemicals, with >80,000 synthetic compounds still insufficiently tested to interpret their effects on human health; despite rising environmental awareness, “green intelligence” about synthetic substances is often unavailable, distorted, kept secret, or poorly presented. Wargo, author of Our Children’s Toxic Legacy, offers a vision for a safer future through prevention, transparency, and awareness. (ENVIRONMENT * POLLUTION * HEALTH AND POLLUTION * CHEMICALS AND HEALTH)
* Improving Medical Outcomes: The Psychology of Doctor-Patient Visits. Fred Leavitt (Prof of Psychology, California State U-East Bay) and Jessica Leavitt (California Board of Vocational Nursing). Lanham MD: Rowman & Littlefield, June 2011, 210p, $32.95 (also e-book). Getting the most out of office visits and other contacts with medical professionals is essential to receiving good care. Considers doctor-patient interactions and the various factors that affect medical outcomes, which play a huge role in medicine. For many medical conditions, nonspecific factors are more important than specific treatments. Gives specific strategies for improving interaction between doctors and patients, and encourages patients to take the lead in improving their own outcomes.
(HEALTH * MEDICAL OUTCOMES AND DOCTOR-PATIENT INTERACTION)
* Primary Care 2025: A Scenario Exploration. Institute for Alternative Futures (Clem Bezold, Chair and Senior Futurist) and The Kresge Foundation. Alexandria VA: IAF, Jan 2012 (www.altfutures.org/primarycare2025). Health care in the US cost $2.57 trillion in 2011 or 17% of GDP, and is expected to grow to 20% of GDP by 2020. While other sectors have learned to do more with less, the number of US health care employees grew between 1990 and 2010, resulting in lower per capita productivity. Health care premiums have increased 131% since 1999, compared to a 38% in worker earnings and an inflation rate of 28% in the same period. Working with >50 national health care leaders, IAF has created four scenarios: 1) Many Needs, Many Models: an extension of health care as we know it, with a shortage of primary care physicians, increased emphasis on disease prevention, growth in electronic records, a shift from employee-based insurance to health insurance exchanges, and growing disparities in access to and quality of primary care based on income and where people live; 2) Lost Decade, Lost Health: more uninsured patients (with some resorting to black market care and unreliable online advice), declining income for physicians; patients with good insurance have access to great care enhanced by advanced technology; 3) Primary Care that Works for All: nearly universal health care coverage, with 85% of patients using integrated systems staffed by collaborative teams; primary care teams join with community partners to address factors that affect a community’s health; 4) I Am My Own Medical Home: 40% of patients opt for consumer-directed health plans that include catastrophic insurance with high deductibles; savvy consumers use advanced technology such as biomonitors and wellness/disease management apps; large vendors offer fee avatar-based health coaching. All four scenarios forecast that electronic records will become ubiquitous, and community health centers will give high-quality care to low-income people. (HEALTH * PRIMARY CARE 2025: U.S. SCENARIOS)
* Inside National Health Reform. John E. McDonough DPH (Prof of Public Health, Harvard U; Distinguished Fellow in Public Health, CUNY-Hunter College). Berkeley: U of California Press, Sept 2011, 339p, $34.95. The Senior Advisor on National Health Reform to the US Senate, who also played a major role in the 2006 Massachusetts health reform law (so-called “Romney Care”), describes the new Affordable Care Act signed by President Obama in 2010. A better reform law could have been written, but “the ACA is close to the best reform that could be achieved in the 111th Congress, and close to the best reform achievable at least since 1993-94.” It is a “landmark in US health reform” and in US social policy legislation. Some concluding thoughts: 1) “the ACA will be revisited and revised repeatedly for years to come”; 2) affordability for new enrollees will be a key test, especially in the long term; 3) the ACA’s fiscal future is as uncertain as its affordability guarantees (the CBO estimates a 10-year federal budget savings of $143 billion and savings in the second decade as much as $1 trillion; one well-placed conservative analyst, however, estimates that the new reform law will raise the federal deficit by >$500 billion in the first ten years, and by nearly $1.5 trillion in the following decade); 4) reforms that optimists hope will bend the cost curve include health insurance exchanges, an excise tax on high-cost insurance plans, reducing administrative costs, promoting prevention and wellness, strengthening primary care, quality measures and priorities, promoting high-value care, a center for innovation, reducing avoidable hospital readmissions, and examining payment bundling; 5) the ACA has the potential to do enormous good for the health needs of minorities, and to reduce racial and ethnic health disparities, as was the case for the 2006 Massachusetts health reform. (HEALTH * AFFORDABLE CARE ACT * HEALTH CARE REFORM: U.S.)