Health care provision in the United States remains a critical policy issue. Despite large-scale organizational transformations in hospitals, changes in the ways that health care is delivered, and changes in the relations between patients and the staffs who provide health care services, health institutions remain financially unstable even as they have grown in size. Mergers and new networks and systems have emerged, and revenue streams continue to grow. Experts no longer view such developments as holding the answer to continuing problems of the health care system. Focusing on changes in the health care sector in New York City during the 1990s, this volume considers physicians and other health care workers, primary and ambulatory care sites, and hospitals and medical centers. It explores the impact of institutional realignments and managed care in New York City. It examines the accelerated destabilization of health care financing and delivery at the end of the twentieth century in the nation at large as well as in New York State and New York City. Ginzberg and his colleagues describe what might happen in the next decade in the nation's largest metropolis and locate the probable outcome in the space between these two extremes. They focus on how the health marketplace may be altered by 2010 when it faces its greatest challenges, a year before the first members of the baby boom generation become eligible for Medicare. This literate and informative volume elucidates changes that have occurred in the health care sector during the decade of the 1990s and offers an expert assessment of what might happen over the next decade. Policymakers, health care officials, and medical personnel will find this highly informative reading. Eli Ginzberg is A. Barton Hepburn Professor Emeritus at the Graduate School of Business, and Director of the Eisenhower Center for the Conservation of Human Resources at Columbia University. His work in social policy, health care, human resources, the special needs of the poor, the young and the aged, place Ginzberg in a special category: activist scholar rather than academic-turned-activist. Howard Berliner is associate professor, Program in Health Services Management and Policy, Milano Graduate School of Management and Urban Policy, New School for Social Research. Panos Minogiannis is a political science doctoral candidate in the division of Sociomedical Sciences, Columbia University and a research associate at the Eisenhower Center. Miriam Ostow was the long term chief of health policy studies at the Eisenhower Center and co-author of many of its earlier publications on health policy.

This work, examines the transformation of American hospitals from a series of community- based charitable institutions into the large, bureaucratic system that existed by the end of the Progressive era. Originally published in 1986. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

Traces the development of the sanitary and health problems of New York City from earliest Dutch times to the culmination of a nineteenth-century reform movement that produced the Metropolitan Health Act of 1866, the forerunner of the present New York City Department of Health. Professor Duffy shows the city's transition from a clean and healthy colonial settlement to an epidemic-ridden community in the eighteenth century, as the city outgrew its health and sanitation facilities. He describes the slow growth of a demand for adequate health laws in the mid-nineteenth century, leading to the establishment of the first permanent health agency in 1866.

No One Was Turned Away is a book about the importance of public hospitals to New York City. At a time when less and less value seems to be placed on public institutions, argues author Sandra Opdycke, it is both useful and prudent to consider what this particular set of public institutions has meant to this particular city over the last hundred years, and to ponder what its loss might mean as well. Opdycke suggests that if these public hospitals close or convert to private management--as is currently being discussed--then a vital element of the civic life of New York City will be irretrievably lost. The story is told primarily through the history of Bellevue Hospital, the largest public hospital in the city and the oldest in the nation. Following Bellevue through the twentieth century, Opdycke meticulously charts the fluctuating fortunes of the city's public hospital system. Readers will learn how medical technology, urban politics, changing immigration patterns, economic booms and busts, labor unions, health insurance, Medicaid, and managed care have interacted to shape both the social and professional environments of New York's public hospitals. Having entered the twentieth century with high hopes for a grand expansion, Bellevue now faces financial and political pressures so acute that its very future is in doubt. In order to give context to the Bellevue experience, Opdycke also tracks the history of a private facility over the same century: New York Hospital. By noting the points at which the paths of these two mighty institutions have overlapped--as well as the ways in which they have diverged--this book clearly and persuasively highlights the significance of public hospitals to the city. No One Was Turned Away shows that private facilities like New York Hospital have generally provided superb care for their patients, but that in every era they have also excluded certain groups. This exclusion has occurred for various reasons, such as patients' diagnoses, their social characteristics, behavior, or financial status--or simply because of a lack of unoccupied beds. Fortunately, however, year in and year out, Bellevue and its fellow public facilities have acted as the city's medical safety net. Opdycke's book maintains that public hospitals will be as essential in the future as they have been in the past. This is a thoughtful and well-written study that will appeal to anyone interested in the history of medicine, public policy, urban affairs, or the City of New York.