Health at Risk

Health at Risk: America's Ailing Health System--and How to Heal It

EDITED BY JACOB S. HACKER
Copyright Date: 2008
Pages: 152
https://www.jstor.org/stable/10.7312/hack14602
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  • Book Info
    Health at Risk
    Book Description:

    In this volume, the nation's leading advisors on health policy and financing appraise America's ailing healthcare system and suggest reasonable approaches to its rehabilitation. Each chapter confronts a major challenge to the country's health security, from runaway costs and uneven quality of care to declining levels of insurance coverage, medical bankruptcy, and the growing enthusiasm for health plans that put patients in charge of risk and cost. Bringing the latest research to bear on these issues, contributors diagnose the problems of our present system and offer treatments grounded in extensive experience. Free of bias and rhetoric, Health at Risk is an invaluable tool for those who are concerned with the current state of healthcare and are eager to effect change.

    eISBN: 978-0-231-51861-1
    Subjects: Health Sciences, Political Science, History

Table of Contents

  1. Front Matter
    (pp. [i]-[iv])
  2. Table of Contents
    (pp. [v]-[viii])
  3. Introduction
    (pp. 1-9)
    JACOB S. HACKER

    Major reform of American health insurance has once again risen to the top of the political agenda. For the past fifteen years, large-scale changes to the nation’s $2.2 trillion medical complex were considered infeasible — too costly, too politically controversial, and too threatening to existing stakeholders to stand any chance of enactment. But for at least the fifth time since reformers struggled to enact compulsory health plans for workers at the state level in the 1910s, the goal of guaranteeing insurance coverage for working Americans has reignited as a burning issue.¹

    Two concerns dominate the growing public discussion: the dwindling...

  4. CHAPTER ONE The Transformation of American Health Insurance
    (pp. 10-31)
    JILL QUADAGNO and J. BRANDON MC KELVEY

    Each year for more than a quarter century, the number of people without health insurance has continued to rise, to forty-seven million in 2007.¹ The only reason the situation does not look worse is that the government is picking up the slack — through Medicare and Medicaid and through the coverage provided to public employees. As public debate once again turns to the lack of health insurance, the choices offered differ in fundamental ways. At one end of the political spectrum are those who would base reform on a social insurance model, where risks are pooled broadly and costs distributed...

  5. CHAPTER TWO Uninsured in America: New Realities, New Risks
    (pp. 32-65)
    KATHERINE SWARTZ

    Why is it so important to have health insurance? It prevents financial ruin and provides access to medical care that leads to better health outcomes, especially if a person has a chronic disease such as cancer or an accident requiring expensive care.

    This answer is less obvious than it sounds since it is often assumed that people without health insurance can get the same medical care as insured people. As President Bush said in a speech on July 10, 2007: “I mean, people have access to health care in America. After all, you just go to an emergency room.”¹ What...

  6. CHAPTER THREE Get Sick, Go Broke
    (pp. 66-87)
    DEBORAH THORNE and ELIZABETH WARREN

    No family wants to file for bankruptcy. To do so is an unmistakable sign of personal failure.¹ It is an indelible mark that the person filing will remember long after the creditors have moved on and the court records have been archived. For a family facing bankruptcy in the aftermath of a medical problem, the pill is especially bitter. Unfortunately, about half of all families filing for bankruptcy do so as the result of a serious medical problem.²

    Moreover, bankruptcy files reveal that America’s health insurance system offers no guarantees that those with medical problems will be spared. Fully three-quarters...

  7. CHAPTER FOUR Just How Good Is American Medical Care?
    (pp. 88-105)
    ELIZABETH A. MC GLYNN, DAVID MELTZER and JACOB S. HACKER

    For decades, American medical care has been portrayed as the best in the world — a utopia of high-tech treatments, cutting-edge research, and expeditious and effective interventions. In this still-dominant view, the problems in U.S. health care concern cost and access, not the quality of care that Americans receive. In recent years, however, this glossy image has come under increasing scrutiny.¹ A large and growing body of research — some of it longstanding but much of it emerging in the last decade — has carefully examined the question “Just how good is American medical care?” The answer, it turns out,...

  8. CHAPTER FIVE The New Push for American Health Security
    (pp. 106-136)
    JACOB S. HACKER

    In the spring of 1962, as Ray Charles’s “Unchain My Heart” was climbing the singles charts, another recording by a noted performer was playing in American living rooms across the country. The words may not have been as catchy as Charles’s, but they were no less urgent. The speaker on the vinyl LP warned about a bill before Congress that would bring about “socialized medicine” in the United States, imploring listeners to enlist their friends and neighbors to write in opposition:

    Write those letters now; call your friends, and tell them to write them. If you don’t, this program, I...

  9. List of Contributors
    (pp. 137-140)