Health care spending in the United States today is approaching 20 percent of GDP, yet levels of U.S. population health have been declining for decades relative to other wealthy and even some developing nations. How is it possible that the United States, which spends more than any other nation on health care and insurance, now has a population markedly less healthy than those of many other nations? Sociologist and public health expert James S. House analyzes this paradoxical crisis, offering surprising new explanations for how and why the United States has fallen into this trap. In Beyond Obamacare, House shows that health care reforms, including the Affordable Care Act, cannot resolve this crisis because they do not focus on the underlying causes for the nation’s poor health outcomes, which are largely social, economic, environmental, psychological, and behavioral. House demonstrates that the problems of our broken health care and insurance system are interconnected with our large and growing social disparities in education, income, and other conditions of life and work, and calls for a complete reorientation of how we think about health. He concludes that we need to move away from our misguided and almost exclusive focus on biomedical determinants of health, and to place more emphasis on addressing social, economic, and other inequalities. House’s review of the evidence suggests that the landmark Affordable Care Act of 2010, and even universal access to health care, are likely to yield only marginal improvements in population health or in reducing health care expenditures. In order to rein in spending and improve population health, we need to refocus health policy from the supply side—which makes more and presumably better health care available to more citizens—to the demand side—which would improve population health though means other than health care and insurance, thereby reducing need and spending for health care. House shows how policies that provide expanded educational opportunities, more and better jobs and income, reduced racial-ethnic discrimination and segregation, and improved neighborhood quality enhance population health and quality of life as well as help curb health spending. He recommends redirecting funds from inefficient supply-side health care measures toward broader social initiatives focused on education, income support, civil rights, housing and neighborhoods, and other reforms, which can be paid for from savings in expenditures for health care and insurance. A provocative reconceptualization of health in America, Beyond Obamacare looks past partisan debates to show how cost-efficient and effective health policies begin with more comprehensive social policy reforms.

This book argues that two principal factors are inhibiting Native students from transitioning from school to college and from succeeding in their post-secondary studies. It presents models and examples of pathways to success that align with Native American students’ aspirations and cultural values.Many attend schools that are poorly resourced where they are often discouraged from aspiring to college. Many are alienated from the educational system by a lack of culturally appropriate and meaningful environment or support systems that reflect Indigenous values of community, sharing, honoring extended family, giving-back to one’s community, and respect for creation.The contributors to this book highlight Indigenized college access programs--meaning programs developed by, not just for--the Indigenous community, and are adapted, or developed, for the unique Indigenous populations they serve. Individual chapters cover a K-12 program to develop a Native college-going culture through community engagement; a “crash course” offered by a higher education institution to compensate for the lack of college counseling and academic advising at students’ schools; the role of tribal colleges and universities; the recruitment and retention of Native American students in STEM and nursing programs; financial aid; educational leadership programs to prepare Native principals, superintendents, and other school leaders; and, finally, data regarding Native American college students with disabilities. The chapters are interspersed with narratives from current Indigenous graduate students.This is an invaluable resource for student affairs practitioners and higher education administrators wanting to understand and serve their Indigenous students.

This book combines analysis of policy and empirically based studies on gender, education, and development.

Health care professionals, activists and scholars weigh in on how the U.S. can address the shortcomings of the "medical industrial complex" and extend affordable health care to all “I’ve still got my health so what do I care?” goes a lyric in an old Cole Porter song. Most of us, in fact, assume we can’t live full lives, or take on life’s challenges, without also assuming that we’re basically healthy and will be for the foreseeable future. But these days, our health and well-being are sorted through an ever-expanding, profit-seeking financial complex that monitors, controls, and commodifies our very existence. Given that our access to competent, affordable health care grows more precarious each day, the arrival of Health Care Under the Knife could not be more timely. In this empowering book, noted health-care professionals, scholars, and activists—including editor Howard Waitzkin—impart their inside knowledge of the medical system: what’s wrong, how it got this way, and what we can do to heal it. The book is comprised of individual essays addressing the “medical industrial complex,” the impact of privatization and cutbacks under neoliberalism, the nature of health-care work, and the intersections between health care and imperialism, both historically and at present. We see how the health of our bodies in “developed” countries is tied to the health of the bodies of the labor force in the Global South, and how the World Bank and the International Monetary Fund are linked strangely, inextricably, to our physical well-being. But this analysis would not be complete without the book’s final section, which delivers invaluable guidance for how to change this system. Recounting case studies and successful efforts for creating a more humane community, this book ultimately gives us hope that our health-care system can be rescued and made an integral part of a new and radically different society.