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Synopsis
Challenges the prevailing idea that market-driven health care is the best way to resolve issues of cost, access, and health status. Civic community, a variation of civil society, is offered as an alternative paradigm for setting the rules by which health care is restructured.
Doody Review Services
Reviewer:John F. Rotilie, MD(Aspen Medical Group)
Description:This book describes the problems of market based healthcare restructuring and proposes a community based alternative.
Purpose:The purpose is to challenge the prevailing market oriented approach in healthcare, and present the theory and design for "a middle ground" approach that preserves individual autonomy without sacrificing equality and creates long term collective value without causing undue centralization. This is an important discussion, applicable not only to healthcare, but also to education and transportation. Society loses both with commodification and bureaucracy. In healthcare, it is perhaps not to late to try a "third way," and this book is a useful plea.
Audience:This book will appeal to health policy activists, political scientists, sociologists, and legislators.
Features:Clear arguments for the likely shortfalls of market oriented healthcare are provided, and useful social theory and data for support are presented. Examples of community based programs are included to promote the author's alternative.
Assessment:The author succeeds in demonstrating a need for a "third way," yet could have been more convincing about her alternative approach if she was more clear about the dynamics that drive the current healthcare restructuring. Central government and the corporate sector collude much more symbiotically than meets the eye and jointly suppress community autonomy in our society. A viable "third way" will require individual rather than employer based healthcare insurance and some kind of dividing up of healthcare into parts that must be universal and available regardless of cost, such as prevention and catastrophic health coverage, and parts that can be consumerist and market priced, such as minor illness care and care of stable, chronic conditions. A national board for benefits and standards of care would likely be a necessary component.