The Social Transformation Of American Medicine

Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review

Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review

Few contemporary social problems in the U.S. affect more people daily than those within the American health care system. Social Movements and the Transformation of American Health Care is the first collection of essays to examine dynamics of change in health care institutions through the lens of contemporary theory and research on collective action. Gathering scholars from medicine, health policy, history, sociology, and political science, the book considers health-related social movements from four distinct levels, concentrating on movements seeking changes in the regulation, financing, and distribution of health resources; changes in institutions in public health, bio-ethics, and other fields; interactions between social movements and professions; and the cultural dominance of the medical model, and the difficulties for framing and legitimizing new issues in health care it poses. At a time when American health care is long overdue for major changes, this book takes an essential look at movements, policies, and institutions to identify the common constraints and opportunities for reform within the health care system.

In no other country has health care served as such a volatile flashpoint of ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of legislation in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues. Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change. He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990sùand of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt RomneyÆs reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continuesùa penetrating account of how health care became such treacherous terrain in American politics.

Social medicine, starting two centuries ago, has shown that social conditions affect health and illness more than biology does, and social change affects the outcomes of health and illness more than health services do. Understanding and exposing sickness-generating structures in society helps us change them. This first book providing a critical introduction to social medicine sheds light on an increasingly important field. The authors draw on examples worldwide to show how principles based on solidarity and mutual aid have enabled people to participate collaboratively to construct health-promoting social conditions. The book offers vital information and analysis to enhance our understanding regarding the promotion of health through social and individual means; the micro-politics of medical encounters; the social determination of illness; the influences of racism, class, gender, and ethnicity on health; health and empire; and health praxis, reform, and sociomedical activism. Illustrations are included throughout the book to convey these key themes and important issues, as well as on Routledge’s webpage for the book, under the Support Materials tab. The authors offer compelling ways to understand and to change the social dimensions of health and health care. Students, teachers, practitioners, activists, policy makers, and people concerned about health and health care will value this book, which goes beyond the usual approaches of texts in public health, medical sociology, health economics, and health policy.

Is management a profession? Should it be? Can it be? This major work of social and intellectual history reveals how such questions have driven business education and shaped American management and society for more than a century. The book is also a call for reform. Rakesh Khurana shows that university-based business schools were founded to train a professional class of managers in the mold of doctors and lawyers but have effectively retreated from that goal, leaving a gaping moral hole at the center of business education and perhaps in management itself. Khurana begins in the late nineteenth century, when members of an emerging managerial elite, seeking social status to match the wealth and power they had accrued, began working with major universities to establish graduate business education programs paralleling those for medicine and law. Constituting business as a profession, however, required codifying the knowledge relevant for practitioners and developing enforceable standards of conduct. Khurana, drawing on a rich set of archival material from business schools, foundations, and academic associations, traces how business educators confronted these challenges with varying strategies during the Progressive era and the Depression, the postwar boom years, and recent decades of freewheeling capitalism. Today, Khurana argues, business schools have largely capitulated in the battle for professionalism and have become merely purveyors of a product, the MBA, with students treated as consumers. Professional and moral ideals that once animated and inspired business schools have been conquered by a perspective that managers are merely agents of shareholders, beholden only to the cause of share profits. According to Khurana, we should not thus be surprised at the rise of corporate malfeasance. The time has come, he concludes, to rejuvenate intellectually and morally the training of our future business leaders.

A comprehensive history of sickness, health, and medicine in America from Colonial times to the present. In Health Care in America, historian John C. Burnham describes changes over four centuries of medicine and public health in America. Beginning with seventeenth-century concerns over personal and neighborhood illnesses, Burnham concludes with the arrival of a new epoch in American medicine and health care at the turn of the twenty-first century. From the 1600s through the 1990s, Americans turned to a variety of healers, practices, and institutions in their efforts to prevent and survive epidemics of smallpox, yellow fever, cholera, influenza, polio, and AIDS. Health care workers in all periods attended births and deaths and cared for people who had injuries, disabilities, and chronic diseases. Drawing on primary sources, classic scholarship, and a vast body of recent literature in the history of medicine and public health, Burnham finds that traditional healing, care, and medicine dominated the United States until the late nineteenth century, when antiseptic/aseptic surgery and germ theory initiated an intellectual, social, and technical transformation. He divides the age of modern medicine into several eras: physiological medicine (1910s–1930s), antibiotics (1930s–1950s), technology (1950s–1960s), environmental medicine (1970s–1980s), and, beginning around 1990, genetic medicine. The cumulating developments in each era led to today's radically altered doctor-patient relationship and the insistent questions that swirl around the financial cost of health care. Burnham's sweeping narrative makes sense of medical practice, medical research, and human frailties and foibles, opening the door to a new understanding of our current concerns.

The problems of medical care confront us daily: a bureaucracy that makes a trip to the doctor worse than a trip to the dentist, doctors who can't practice medicine the way they choose, more than 40 million people without health insurance. "Medical care is in crisis," we are repeatedly told, and so it is. Barely one in five Americans thinks the medical system works well. Enter David M. Cutler, a Harvard economist who served on President Clinton's health care task force and later advised presidential candidate Bill Bradley. One of the nation's leading experts on the subject, Cutler argues in Your Money or Your Life that health care has in fact improved exponentially over the last fifty years, and that the successes of our system suggest ways in which we might improve care, make the system easier to deal with, and extend coverage to all Americans. Cutler applies an economic analysis to show that our spending on medicine is well worth it--and that we could do even better by spending more. Further, millions of people with easily manageable diseases, from hypertension to depression to diabetes, receive either too much or too little care because of inefficiencies in the way we reimburse care, resulting in poor health and in some cases premature death. The key to improving the system, Cutler argues, is to change the way we organize health care. Everyone must be insured for the medical system to perform well, and payments should be based on the quality of services provided not just on the amount of cutting and poking performed. Lively and compelling, Your Money or Your Life offers a realistic yet rigorous economic approach to reforming health care--one that promises to break through the stalemate of failed reform.