The prospect of caring for elderly relatives who may be too old, fragile, or forgetful to manage on their own looms large for millions of women and men who are unprepared for the difficulties such an experience can bring. Written by a daughter of aging parents, this book takes an honest, unflinching look at aging in America, weaving together personal stories with current medical information to trace exactly how social and health care policies are affecting daily lives. Judith Steinberg Turiel addresses such topics as healthy aging and independent living; mental impairment brought on by Alzheimer's, other dementias, and depression; women as caregivers; health care rationing; the power of prescription drug makers; end-of-life care; and prospects for Medicare. Her book clearly demonstrates the pressing need for quality health care for people of all ages—through universal, publicly funded health insurance.

Proof that high health care spending is linked directly to poverty. In Poverty and the Myths of Health Care Reform, Dr. Richard (Buz) Cooper argues that US poverty and high health care spending are inextricably entwined. Our nation's health care system bears a financial burden that is greater than in any other developed country in large part because impoverished patients use more health care, driving up costs across the board. Drawing on decades of research, Dr. Cooper illuminates the geographic patterns of poverty, wealth, and health care utilization that exist across neighborhoods, regions, and states—and among countries. He chronicles the historical threads that have led to such differences, examines the approaches that have been taken to combat poverty throughout US history, and analyzes the impact that structural changes now envisioned for clinical practice are likely to have. His research reveals that ignoring the impact of low income on health care utilization while blaming rising costs on waste, inefficiency, and unnecessary care has led policy makers to reshape clinical practice in ways that impede providers who care for the poor. The first book to address the fundamental nexus that binds poverty and income inequality to soaring health care utilization and spending, Poverty and the Myths of Health Care Reform is a must-read for medical professionals, public health scholars, politicians, and anyone concerned with the heavy burden of inequality on the health of Americans.

The nine regional Atlases provide the data and analysis for specific hospital service areas with which these and other questions can be addressed. Strategies to address the question of the appropriate levels of supply must be developed in the absence of detailed understanding of the nature of health care needs, medical care outcomes, and what patients want. One such strategy begins by examining individual communities and comparing them to others. Such comparisons lead naturally to a search for "efficiently" operated health plans or communities--those with an adequate but not excessive supply of resources.

This is a thoroughgoing revision of the first edition of this classic text and reference, published by Plenum in 1992. The authors convey the general principles that underlie this applied subdiscipline and demonstrate how the merging of demography and health care impacts on the planning processes of a range of health care organizations.

Americans want a long life and most of us will get to live into our 80's and beyond, but we have not squarely faced the challenges of living well in the last years of long lives. This book lays out a thoroughly pragmatic way to organize service delivery and financing so that Americans could count on living comfortably and meaningfully through the period of disability and illness that most will experience in the last years of life - all at a cost that families and taxpayers can sustain. MediCaring Communities offers to customize care around the priorities of elders and their families and to manage the local care system so it is reliable and efficient.Three out of four of us will need long-term care. The period of needing someone's help every day now lasts more than two years, on average. Most of us will not have saved enough to get through this part of life without financial help from family or government - indeed, we'll spend almost half of our total lifetime healthcare expenditures in this last part of life, mostly on personal care that is not covered by Medicare. We have not yet required housing to be modified for living with disabilities or secured a ready supply of home-delivered food, and we certainly have not required medical care to focus on the patient and family priorities in order to enable the last years to be meaningful and comfortable. Family caregiving will be a crisis as families become smaller, more dispersed, older, and facing inadequate retirement income for the younger generation. MediCaring Communities improve care by building care plans around the health needs and living situation of the elderly person and family, and especially from respecting their choices about priorities. The improvements in service delivery arise from integrating supportive services at home with customized medical care and installing local monitoring and management. The improvements in finance arise from harvesting savings from the current overuse of medical tests and treatments in this part of life. These come together in MediCaring Communities.Strong evidence supports each component, but the real strength is in the combination, where savings support critical community-based services, communities build the necessary environment, and elders and their families craft their course with the help of interdisciplinary teams. This book lays it out, using expansion of PACE (The Program of All-Inclusive Care of the Elderly) as the test case. The book provides a strong and complete guide to serious reform, and just in time for the aging of the Boomers which will escalate the needs dramatically during the 2030's. Now is the time to act.Advance Praise for MediCaring Communities"For decades, Joanne Lynn's has been the clearest, strongest, most soulful voice in America for modernizing the ways in which we care for frail elders. This essential book is her masterpiece. It offers a magisterial, evidence-based vision of that new care, and an entirely plausible pathway for reaching it. Facing a tsunami of aging, our nation simply cannot afford to ignore this counsel."-Donald M. Berwick, MD, President Emeritus and Senior Fellow, Institute for Healthcare Improvement, and former Administrator, Centers for Medicare & Medicaid Services."MediCaring Communities integrates good geriatrics and long-term services and supports, and building upon an expanded PACE program can be a tangible start. We should try this!"-Jennie Chin Hansen, Lead in Developing PACE; Past President, AARP; and Past CEO of On Lok Senior Health Services and the American Geriatrics Society.