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Cover -- Half Title -- Title -- Copyright -- Contents -- List of Tables -- Introduction -- Retrospective on Health Care Issues -- Future Forces Affecting the Health Care System -- Final Comment -- 1 Health Care Forecasting: A Retrospective, 1970-1980 -- Some Reflections on Forecasting -- Forecasts and the Health Care Delivery System -- Forecasting National Health Expenditures: 1970-1980 -- Forecasting Human Resources Supply and Requirements: 1970-1980 -- Forecasting Capital Needs and Bed Supply: 1970-1980 -- Forecasting Changes in Technology: 1970-1980 -- Forecasting Organizational Change in the Health Care Delivery System: 1970-1980 -- Summary and Conclusions -- Notes -- 2 Changing Employment Trends in the U.S. Health Care Delivery System: 1985-2000 -- Health Sector Employment by Specific Place of Employment -- Health Sector Employment by Occupation -- Gender and Race Issues -- Policy Issues and Conclusions -- Notes -- 3 Critical Issues in Capital for Health Care -- The Roles of Capital in Health Care -- Estimates of Capital Need -- Borrowing and the Bond Market -- Other Issues in Health Capital Policy -- The Academic Health Center and Access to Capital -- Conclusion -- Notes -- 4 The Rapid Progress of Medical Technology -- Capital and Technology -- Cost of Technology Issues -- Issues in Technology Diffusion -- New and Emerging Technologies -- Transplantation of Human Organs -- Other Issues -- Conclusion -- Notes -- About the Author -- Index.

This paper analyzes the ideological content of three recent and popular books: Medical Nemesis by Ivan Illich, Who Shall Live ? by Victor Fuchs and The End of Medicine by Rick Carlson. These books are shown to use a victim-blaming epidemiology that obscures the relationship between production and disease, to promote individual responses to health problems, to undermine petit-bourgeois control of medical care delivery, and to justify cutbacks of medi cal care service.

Academic health centres (AHCs) have played a key role in propelling the United States to world leadership in technological advances in medicine. At the same time, however, many of these urban-based hospitals have largely ignored the medical care of their poor neighbours. Now one of the leading experts in American health policy and economics ponders whether current and proposed changes in the financing and delivery of medical care will result in a realignment between AHCs and the poor

Addressed is the political & theoretical meaning of the holistic health movement which has arisen in the United States in the 1970s. A variety of holistic theories & therapies which attempt to view the patient as an integration of body, mind, & spirit are challenging the form & content of dominant Western scientific medicine. Criticized are the holistic health movement's largely privatistic & individualistic tendencies; it may provide new avenues for corporate & petty-bourgeois marketing efforts in the context of the present broad dissatisfaction with medicine's current organization. It is believed that holistic medicine contains many elements that may be forged into a strong people's health movement. Described is how the rise of scientific medicine in the late nineteenth century led to the demise of a prior holistic & political understanding of health. The social medicine movement of the 1840s in Europe possibly contributed politically to the holistic health movement today. An understanding of health & disease must recognize a totality of the human organism within its particular social context, & address the nature of the political economy which is the social origin of many diseases in advanced capitalist society. Modified AA.

Intro -- Half Title -- Title Page -- Copyright Page -- Contents -- Preface -- 1 Why New York City? -- 2 The Changing Health Care Delivery System -- 3 Cascade of Dollars -- 4 The Role of the State -- 5 How Much Did Health Care for the Poor Improve? -- 6 Innovative Programs -- 7 Medicaid Managed Care -- 8 Destabilization and Beyond -- 9 Lessons for Policy -- Selected Bibliography -- Index