Inescapable Decisions: The Imperatives of Health Reform"Inescapable Decisions" examines the disarray in the American health care system and proposes major corrective strategies. Mechanic shows that the high-technology interventionist type of medicine commonly practiced in the United States has lost its sense of priorities and balance. Expensive and sometimes dangerous procedures of unknown efficacy are used excessively and often inappropriately, while many basic preventive and primary care services remain unavailable to those who need them the most. This incredibly complex system of care operates in an environment of heavy-landed rules and regulations and enormous waste of resources. |
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Page viii
Mechanic shows that much of the neglect of sick and disadvantaged populations results from an approach to health and welfare issues that encourages fragmentation of services . The goal of a workable health system is now a national ...
Mechanic shows that much of the neglect of sick and disadvantaged populations results from an approach to health and welfare issues that encourages fragmentation of services . The goal of a workable health system is now a national ...
Page xii
An increasing component of medical work deals with chronic disease and disabilities , but we have yet to develop a longitudinal approach to clinical care that is sufficiently sensitive to the course of disease in its psychosocial and ...
An increasing component of medical work deals with chronic disease and disabilities , but we have yet to develop a longitudinal approach to clinical care that is sufficiently sensitive to the course of disease in its psychosocial and ...
Page xiii
I suggest that future rationing must involve a blend of approaches , and the real debate should focus on how to best achieve a proper mix . The second set of essays begins to define what I mean by a new health paradigm .
I suggest that future rationing must involve a blend of approaches , and the real debate should focus on how to best achieve a proper mix . The second set of essays begins to define what I mean by a new health paradigm .
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Page 9
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Contents
The American Medical Care System | 3 |
Sources of Countervailing Power in Medicine | 53 |
Professional Judgment and the Rationing of Medical Care | 69 |
Conceptions of Health | 101 |
119 | |
137 | |
153 | |
165 | |
213 | |
Inescapable Decisions | 229 |
Medical Sociology Some Tensions between Theory Method and Substance | 249 |
The Role of Sociology in Health Affairs | 275 |
291 | |
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administrative alternative American approach appropriate assessments associated basic become behavior benefits capitation chronic clinical comparable concept concerns context continue costs coverage decisions deinstitutionalization depends difficult disabilities disease economic effects efforts elderly example expensive experience Financing future groups health care health insurance hospitals important incentives increased individual influence institutions interest interventions involved issues less limited long-term major managed Marty measures Mechanic Medicaid Medicare medicine mental health mentally ill organization patients percent period persons physicians political population possible practice prevention problems procedures professional programs questions rates rationing reform relatively reported require responsibility result risk role situations social sociology structure studies substantially suggest survey symptoms technologies tion treatment types typically United varying