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 vii
Professional Judgment and the Rationing of Medical Care Need for a New Paradigm The Medical Care System in Disarray II . 4. Conceptions of Health 5. Promoting Health and Independence 6. Socioeconomic Status and Health III . 7.
Professional Judgment and the Rationing of Medical Care Need for a New Paradigm The Medical Care System in Disarray II . 4. Conceptions of Health 5. Promoting Health and Independence 6. Socioeconomic Status and Health III . 7.
Page xii
... in a manner sensitive to clinical issues and patient needs . I argue that implicit rationing — that is , establishing budgetary limits within which health professionals must work — offers the most realistic , xii Inescapable Decisions.
... in a manner sensitive to clinical issues and patient needs . I argue that implicit rationing — that is , establishing budgetary limits within which health professionals must work — offers the most realistic , xii Inescapable Decisions.
Page xiii
An effective and sensible health care rationing scheme must take into account the need for flexible response . I suggest that future rationing must involve a blend of approaches , and the real debate should focus on how to best achieve ...
An effective and sensible health care rationing scheme must take into account the need for flexible response . I suggest that future rationing must involve a blend of approaches , and the real debate should focus on how to best achieve ...
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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
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Bibliographic information
| Title | Inescapable Decisions: The Imperatives of Health Reform |
| Author | David Mechanic |
| Publisher | Transaction Publishers |
| ISBN | 1412826225, 9781412826228 |
| Length | 296 pages |
| Export Citation | BiBTeX EndNote RefMan |