Social Medicine Reader, Second Edition

Strauss Ronald P. Strauss

Description

Duke University Press is pleased to announce the second edition of the bestselling Social Medicine Reader. The Reader provides a survey of the challenging issues facing today's health care providers, patients, and caregivers by bringing together moving narratives of illness, commentaries by physicians, debates about complex medical cases, and conceptually and empirically based writings by scholars in medicine, the social sciences, and the humanities. The first edition of The Social Medicine Reader was a single volume. This significantly revised and expanded second edition is divided into three volumes to facilitate use by different audiences with varying interests.Praise for the 3-volume second edition of The Social Medicine Reader:"A superb collection of essays that illuminate the role of medicine in modern society. Students and general readers are not likely to find anything better."-Arnold S. Relman, Professor Emeritus of Medicine and Social Medicine, Harvard Medical SchoolPraise for the first edition:"This reviewer strongly recommends The Social Medicine Reader to the attention of medical educators."-Samuel W. Bloom, JAMA: The Journal of the American Medical AssociationVolume 3:Over the past four decades the American health care system has witnessed dramatic changes in private health insurance, campaigns to enact national health insurance, and the rise (and perhaps fall) of managed care. Bringing together seventeen pieces new to this second edition of The Social Medicine Reader and four pieces from the first edition, Health Policy, Markets, and Medicine draws on a broad range of disciplinary perspectives-including political science, economics, history, and bioethics-to consider changes in health care and the future of U.S. health policy. Contributors analyze the historical and moral foundation of today's policy debates, examine why health care spending is so hard to control in the United States, and explain the political dynamics of Medicare and Medicaid. Selections address the rise of managed care, its impact on patients and physicians, and the ethical implications of applying a business ethos to medical care; they also compare the U.S. health care system to the systems in European countries, Canada, and Japan. Additional readings probe contemporary policy issues, including the emergence of consumer-driven health care, efforts to move quality of care to the top of the policy agenda, and the implications of the aging of America for public policy.Contributors: Henry J. Aaron, Drew E. Altman, George J. Annas, Robert H. Binstock, Thomas Bodenheimer, Troyen A. Brennan, Robert H. Brook, Lawrence D. Brown, Daniel Callahan, Jafna L. Cox, Victor R. Fuchs, Kevin Grumbach, Rudolf Klein, Robert Kuttner, Larry Levitt, Donald L. Madison, Wendy K. Mariner, Elizabeth A. McGlynn, Jonathan Oberlander, Geov Parrish, Sharon Redmayne, Uwe E. Reinhardt, Michael S. Sparer, Deborah Stone

Sujets

• Sociologie, société et politique
• Oncology

Informations

• Publié par: Duke University Press
• Date de parution: 29 août 2005
• Nombre de lectures: 0
• EAN13: 9780822387343
• Langue: English

Extrait

Health Policy, Markets, and Medicine

Second edition V O L U M E I I I

THE SOCIAL MEDICINE READER

Health Policy, Markets, and Medicine

jonathan oberlander larry r. churchill sue e. estroff gail e. henderson nancy m. p. king ronald p. strauss editors

duke university press Durham and London 2005

∫• All rights reserved2005 Duke University Press Printed in the United States of America on acid-free paper$ Typeset in Trump Mediaeval by Keystone Typesetting, Inc. Library of Congress Cataloging-in-Publication Data appear on the last printed page of this book.

Contents

Preface to the Second Edition

Introduction

Part I

1

vii

The Uninsured, Health Care Costs, and Public Programs

The U.S. Health Care System: On a Road to Nowhere?, Jonathan Oberlander5

Wanted: A Clearly Articulated Social Ethic for American Health Care,Uwe E. Reinhardt25

From Bismarck to Medicare—A Brief History of Medical Care Payment in America,Donald L. Madison31

The Sad History of Health Care Cost Containment as Told in One Chart,Drew E. Altman and Larry Levitt

The Unsurprising Surprise of Renewed Health Care Cost Inflation,Henry J. Aaron70

67

The Not-So-Sad History of Medicare Cost Containment as Told in One Chart,Thomas Bodenheimer73

Medicaid and Medicare: The Unanticipated Politics of Public Insurance Programs,Lawrence D. Brown and Michael S. Sparer76

Part II

Managed Care, Markets, and Rationing

Bedside Manna,Deborah Stone

95

Must Goodhmos Go Bad? The Commercialization of Prepaid Group Health Care,Robert Kuttner107

Defending My Life,Geov Parrish

119

Business vs. Medical Ethics: Conflicting Standards for Managed Care,Wendy K. Mariner128

The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation,George J. Annas

Ethics of Queuing for Coronary Artery Bypass Grafting in Canada,Jafna L. Cox158

150

Rationing in Practice: The Case of In Vitro Fertilization, Sharon Redmayne and Rudolf Klein167

Part III

International Perspectives and Emerging Issues

Reforming the Health Care System: The Universal Dilemma,Uwe E. Reinhardt179

Health Care in Four Nations,Thomas Bodenheimer and Kevin Grumbach199

Keeping Quality on the Policy Agenda, Elizabeth A. McGlynn and Robert H. Brook

230

What’s Ahead for Health Insurance in the United States?, Victor R. Fuchs240

Luxury Primary Care—Market Innovation or Threat to Access?,Troyen A. Brennan246

Correspondence: Response to ‘‘Luxury Primary Care’’

Limiting Health Care for the Old,Daniel Callahan

Scapegoating the Aged: Intergenerational Equity and Age-Based Rationing,Robert H. Binstock267

Index to Authors

About the Editors

285

287

255

260

Preface to the Second Edition

Of the six editors of this second edition of theSocial Medicine Reader, five are current members and one a former member of the Department of Social Medicine, University of North Carolina at Chapel Hill School of Medicine. Founded in 1977, the Department of Social Medicine includes scholars in medicine, the social sciences, the humanities, and public health. Its mission is to inform the work and thought of researchers, teachers, and practitioners on the social conditions and characteristics of patients, causes of illness, and barriers to effective care; and the respon- sibilities of the medical profession and other medical institutions. This reader is based on the syllabus of a year-long, required, interdisci- plinary course, Medicine and Society, which has been taught to first-year students at the University of North Carolina at Chapel Hill School of Medicine since 1978. The goal of the course since its inception has been to demonstrate that medicine and medical practice have a profound influ- ence on—and are influenced by—social, cultural, political, and economic forces. Teaching this perspective requires integrating medical and non- medical materials and viewpoints. This reader, therefore, arises not from one or two academic disciplines, but from many fields within medicine, the social sciences, and humanities. With health care and health so central to the political, personal, and financial discourse of the day, this reader provides a starting point for informed, critical analysis. The three volumes of theSocial Medicine Readerrepresent the most engaging, provocative, and informative mate- rials and issues we have traversed with our students. While the origin of these volumes lies in the teaching of medical students, the selections were deliberately made with an eye toward engaging nonmedical readers, both from the interested public and from students in the arts and sciences. The selections challenge standard ways of thinking about medical cate-

gories of disease, social categories of risk, and the types of moral reasoning on which much of the field of bioethics has been based. Their many voices include individual narratives of illness experience, commentaries by phy- sicians, debate about complex medical cases, and conceptually and em- pirically based writings by scholars in medicine, the social sciences, and humanities. These are readings with the literary and scholarly power to convey the complicated relationships between medicine, health, and so- ciety. They do not resolve the most vexing contemporary issues, but il- luminate them. Medicine’s impact on society is multidimensional. Biomedical technol- ogy and practice, including its latest expression, genomic medicine, have profoundly affected our institutions and our social relations. Medicine has affected how we think about the most fundamental, enduring human experiences—conception, birth, maturation, sickness, suffering, healing, aging, and death—and it has shaped the metaphors we use to express our deepest concerns. Medical practices and our responses to them have helped to redefine the meaning of age, race, and gender. Technological advances in medicine have produced ethical dilemmas expressed in new vocabularies of science and economics, as well as in the familiar lan- guages of morality and human relationships. Social influences on medicine are apparent in several ways. First, mod- ern science presumes that the pursuit of knowledge can and should be conducted with an unwavering adherence to neutral, objective observa- tion and experimentation. Yet medical knowledge and practice, like all knowledge and practice, is shaped by political, cultural, and economic forces, within which doctors’ ideas about disease—in fact their very defi- nitions of disease—depend on the roles science and scientists play in par- ticular cultures, as well as on the cultures of laboratory and clinical sci- ence. Medicine tends to reduce the world to a vocabulary of its own, one that seems immune to the vagaries and vicissitudes of culture. But dis- eases are not immutable; they are shaped by person, time, and place, and are identified and endowed with significance only within social and cul- tural contexts. Despite the power of the biomedical model of disease and the increasing specificity of molecular and genetic knowledge, social factors have al- ways influenced the occurrence and course of most diseases. And once disease has occurred, the power of medicine to alter its course is con- strained by the larger social and economic context. Beyond these prob- lems, many medical interventions are themselves of contested or unclear

viiipreface to the second edition

value. Spending on health care in the United States has long outstripped that of other industrialized nations, but that spending has not resulted in a healthier population. What does our medicine produce? Who benefits from these enormous expenditures of resources? Repeatedly, the readings throughout these three volumes make clear that much of what we encounter in science, in society, and in everyday and extraordinary lives is indeterminate, ambiguous, complex, and con- tradictory. And because of this inherent ambiguity, the interwoven selec- tions highlight conflicts—conflict about power and authority, autonomy and choice, security and risk. By critically analyzing these and many other related issues, we can open up possibilities, change what seems inevi- table, and practice medical education and doctoring with an increased capacity for reflection and self-examination. The goal is to ignite and to fuel the inner voices of social, human, and moral analysis among health care professionals, and among us all. Any collection of readings like the three volumes that make up the Social Medicine Reader is open to challenges about what has been in- cluded and what has been left out. This collection is no exception. The study of medicine and society is dynamic, with large and ever expanding bodies of new literature from which to draw. We have omitted some read- ings widely considered ‘‘classics’’ and included some readings that are classic only in our experience. We have chosen to include material with literary and scholarly merit and that has worked well in the classroom, provoking discussion and engaging readers’ imaginations. These readings invite self-conscious, multilevel, critical examination, a work of reading and discussion that is inherently difficult but educationally rewarding. The first edition of theSocial Medicine Readerwas a single volume. We decided to make the second edition three volumes to facilitate use by dif- ferent audiences with different interests; however, the three volumes also function as an integrated whole. Volume I,Patients, Doctors, and Illness, examines the experience of illness, the roles and training of health care professionals and their relationships with patients, ethics in health care, and experiences and decisions at the end of life. It includes fictional and nonfiction narratives and poetry; definitions and case-based discussions of moral precepts in health care, such as truth telling, informed consent, privacy, autonomy, and beneficence; and scholarly readings providing le- gal, ethical, and practical perspectives on many familiar but persistent ethical and social questions raised by illness and health care. Volume II, Social and Cultural Contributions to Health, Difference, and Inequality,

ix