The unique composition and configuration of doctors and hospitals in the US is leading to a crisis in primary care provision. There are significantly more specialists than generalists, and many community hospitals and outpatient facilities are concentrated in affluent areas with high rates of comprehensive insurance coverage. These particular features present difficult challenges to policymakers seeking to increase access to care. Carl F. Ameringer shows why the road to universal healthcare is not built on universal finance alone. Policymakers in other countries successfully align finance with delivery to achieve better access, lower costs, and improved population health. This book explains how the US healthcare system developed, and why efforts to expand insurance coverage in the absence of significant changes to delivery will fuel higher costs without achieving the desired results.
Carl F. Ameringer is retired Professor of Health Policy and Politics at Virginia Commonwealth University.
1. Health policy and health care delivery; 2. The scientific practitioner, 1870–1918; 3. Group medical practice and group insurance, 1919–1943; 4. The hospital as community health center, 1945–1965; 5. The turn to market competition, 1965–1995; 6. The emergence of corporate health systems, 1996–2015.
'Anyone curious about why health care is so daunting in the United States will appreciate this well-researched, eminently readable summary of how it is delivered and financed.' Humayun J. Chaudhry, DO, MACP, President and CEO of Federation of State Medical Boards