Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.

"Every social mechanism appears to have a dual potential for good and evil. Prepayment for medical care is no exception. On the one hand, it provides assurance of necessary care as a safeguard to health, economic well-being, and peace of mind. On the other hand, it opens the way to wasteful and harmful care, to price inflation, and to concealed redistributions in socially undesirable directions. The problem is to devise a plan that allows us to reap the most advantages while we incur the fewest drawbacks." Benefits in Medical Care Programs is a comprehensive treatment of this problem. Dr. Donabedian begins with a clear and straight forward analysis of his own assumptions about the social mandate for medical care benefits, the objectives of medical care programs, and the magnitude and distribution of the unmet need that these programs are designed to alleviate. The problem of defining and measuring the need for care is considered within the con text of the data yielded by alternative definitions. The analysis then shifts to the impact of benefits on certain key features of the medical care system. Program benefits are weighed against program objectives, and policy implications are drawn from this comparison. We are shown what can and cannot be accomplished through medical care benefits and what goals are served by specific aspects of existing or proposed plans. Although Dr. Donabedian counsels a fairly thorough reform of existing systems, he remains skeptical about the possibility of designing a perfect system, and he does not hesitate to point out that increased access to care "increases exposure to both what is good and what is bad in our system of medical care. . . The machinery of medical care has a sinister potential for those who fall into it in the wrong place at the wrong time. Dr. Donabedian's previous book Aspects of Medical Care Administration has been called the "bible" of its field. Benefits in Medical Care Programs should prove equally invaluable.

This book explores 120 years of medical image-making to explain how visual representations came to play a central role in medical education and practice. She demonstrates how medical images acquire cultural meaning and influence, shaping professional and popular understandings of health and disease.

This book is about optimizing the use of medicines and medical tests in primary care. It provides a comprehensive resource for students, researchers, health practitioners and administrators seeking information on how to design, implement, scale-up and build capability for interventions and programs that result in changes in prescribing and medical/diagnostic test ordering by health professionals. Drawing on work from Australia, Canada and the United States of America, the book begins with the evidence-base and theoretical frameworks that underpin successful behaviour change programs. It provides details on particular interventions such as clinical audit, academic detailing, choosing wisely and supports for consumers. Real world examples explore the process of designing, implementing and evaluating interventions and the factors that can help and hinder this process. This is a practical text that will be useful to the beginner and more experience program implementation professionals alike.