Saturday, August 3, 2013

"Health Policy: The Decade Ahead"

Not long ago I encountered a helpful book, James M. Brasfield’s Health Policy: The Decade Ahead (Boulder: Lynne Rienner Publishers, 2011). Brasfield is professor of management and director of the Master of Health Administration program at Webster University, where I also teach (and where my wife Beth is president). He was giving an interview about the book in the library coffee shop, as I was drinking coffee, prepping for class, and listening to the interview. Afterward, when I introduced myself and commented that the book sounded so interesting, he gave me a copy and signed it. I decided on my own to share information about the book on this blog.

Of course, our health care system and the Affordable Care Act continue to be discussed in this country. A Facebook friend shared an article--- asked his friends for their opinions. I recommend Brasfield’s book for those who would like to read and learn more about this contemporary issue. He is balanced in his approach---presenting different health care approaches as well as political philosophies---and makes difficult issues clear.

He discusses several topics and issues in nine chapters.

1. The political economy of health care
In this chapter, he provides some of the basic economic aspects of health care, including a brief summary of health care in the 20th century. By 2019, health care will entail nearly 20% of the GNP, up from just under 14% in 2000 and currently 17%.

2. The health policy system
He discusses the basics of government policy-shaping and legislative work concerning health care, in particular that of Congress, and also various government agencies.

3  Medicare: national health insurance for older americans
The Medicare bill was signed by President Johnson in 1965. Brasfield discusses aspects of the program over the past nearly 50 years and considers its long-term prospects.

4. Medicaid: the accidental program
This chapter covers history of this program, and its prospects during the Reagan, Clinton, and Bush 43 administrations.

5. Too much money: uncontrolled costs
Brasfield asks why health care is so expensive in the US compared to some other countries and considers different ideas for addressing high costs. He gives three scenarios for the future.

6. Long-term care: the sleeping giant
He discusses nursing homes and other forms of long-term care, including mental health. This is an important chapter for those of us with family members with needs for ongoing care.

7. Health care reform: the dream deferred
Brasfield discusses the Affordable Care Acts, its background, the aspects of its passage, its key provisions, its costs and cost savings, and its possible future.

8. How other countries do it
The health care systems of the UK, Germany and Canada are examined, as comparisons with the US.

9.  What can we expect by 2021?
What might American health care look like, ten years from this book’s publication?

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