The modern hospital is at once the site of healing, the locus of medical learning and a cornerstone of the welfare state. Its technological and infrastructural costs have transformed health services into one of today's fastest growing sectors, absorbing substantial proportions of national income in both developed and emerging economies. The aim of this book is to examine this growth in different countries, with a main focus on the twentieth century, and also with a backward glance to earlier shaping forces. It will explore the hospital's economic history, the relationship between public and private forms of provision, and the political context in which health systems were constructed. The collection advances the historical world map of different hospital models, ranging across Spain, Brazil, Germany, East and Central Europe, Britain, the United States and China. Collectively, these comparative cases illuminate the complexities involved in each country and bring new historical evidence to current debates on health care organisation, financing and reform.

Essential reading for every American who must navigate the US health care system. Why was the Obama health plan so controversial and difficult to understand? In this readable, entertaining, and substantive book, Stuart Altman—internationally recognized expert in health policy and adviser to five US presidents—and fellow health care specialist David Shactman explain not only the Obama health plan but also many of the intriguing stories in the hundred-year saga leading up to the landmark 2010 legislation. Blending political intrigue, policy substance, and good old-fashioned storytelling, this is the first book to place the Obama health plan within a historical perspective. The authors describe the sometimes haphazard, piece-by-piece construction of the nation’s health care system, from the early efforts of Franklin Roosevelt and Harry Truman to the later additions of Ronald Reagan and George W. Bush. In each case, they examine the factors that led to success or failure, often by illuminating little-known political maneuvers that brought about immense shifts in policy or thwarted herculean efforts at reform. The authors look at key moments in health care history: the Hill–Burton Act in 1946, in which one determined poverty lawyer secured the rights of the uninsured poor to get hospital care; the "three-layer cake" strategy of powerful House Ways and Means Committee Chairman Wilbur Mills to enact Medicare and Medicaid under Lyndon Johnson in 1965; the odd story of how Medicare catastrophic insurance was passed by Ronald Reagan in 1988 and then repealed because of public anger in 1989; and the fact that the largest and most expensive expansion of Medicare was enacted by George W. Bush in 2003. President Barack Obama is the protagonist in the climactic chapter, learning from the successes and failures chronicled throughout the narrative. The authors relate how, in the midst of a worldwide financial meltdown, Obama overcame seemingly impossible obstacles to accomplish what other presidents had tried and failed to achieve for nearly one hundred years.

a Should be of interest to everyone working for a just and caring health system anywhere.a Barbara Ehrenreich"

The field of social inequalities in health continues its vigorous growth in the early years of the 21st century. This volume, following in the footsteps of Vicente Navarro's edited collection The Political Economy of Social Inequalities, is a compilation of recent contributions to the areas of social epidemiology, health disparities, health economics, and health services research. The overarching theme is to describe and explain the evergrowing health inequalities across social class, race, and gender, as well as neighborhood, city, region, country, and continent. The approach of this book is distinctly multi-, trans-, and interdisciplinary: the fields of public health, population health, epidemiology, economics, sociology, political science, philosophy, medicine, and history are all represented here.

This book examines the social, economic and political issues of public health provision in historical perspective. It outlines the development of public health in Britain, Continental Europe and the United States from the ancient world through to the modern state. It includes discussion of: * pestilence, public order and morality in pre-modern times * the Enlightenment and its effects * centralization in Victorian Britain * localization of health care in the United States * population issues and family welfare * the rise of the classic welfare state * attitudes towards public health into the twenty-first century.

Financing Medicine brings together a collection of essays dealing with the financing of medical care in Britain since the mid-eighteenth century, with a view to addressing two major issues: Why did the funding of the British health system develop in the way it did? What were the ramifications of these arrangements for the nature and extent of health care before the NHS? The book also goes on to explore the 'lessons' and legacies of the past which bear upon developments under the NHS. The contributors to this volume provide a sustained and detailed examination of the model of health care which preceded the NHS - an organization whose distinctive features hold such fascination for the scholars of health systems - and their insights illuminate current debates on the future of the NHS. For students and scholars of the history of medicine, this will prove essential reading.

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.