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Michael Pagano - Understanding Health Care in America: Culture, Capitalism, and Communication

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Understanding Health Care in America: Culture, Capitalism, and Communication: summary, description and annotation

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This book examines the current state of American health care using a social science lens to focus on the interdependent, intercultural, economic, and communication aspects of access and delivery.

This text explores how the cultures of health care organizations, health professions, governments, and capitalism, as well as communication, all contribute to a disease-focused, economically driven, technology-centered health care system. It seeks to understand 21st century health care from a macro-level view based on historical realizations and the current plethora of interdependent, but self-serving realities that provide few, if any, incentives for organizational collaboration and change. The fact that the most expensive health care system in the world does not provide the healthiest outcomes is a driving force in this exploration. By reflecting on American values and beliefs regarding health care from philosophical, clinical, communication, and cost perspectives, this text is designed to encourage an organizational transformation at every level, from government to providers to patients.

This comprehensive survey is an important guide for those studying, or working in, health care professions, as well as health care policy and administration. It should also be of interest to any reader who seeks to better understand U.S. health care policy from social science, economic, and/or health communication perspectives.

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Michael Pagano
Understanding Health Care in America: Culture, Capitalism, and Communication

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UNDERSTANDING HEALTH CARE IN AMERICA This book examines the current state of - photo 1
UNDERSTANDING HEALTH CARE IN AMERICA
This book examines the current state of American health care using a social science lens to focus on the interdependent, intercultural, economic, and communication aspects of access and delivery.
This text explores how the cultures of health care organizations, health professions, governments, and capitalism, as well as communication, all contribute to a disease-focused, economically driven, technology-centered health care system. It seeks to understand 21st century health care from a macro-level view based on historical realizations and the current plethora of interdependent, but self-serving realities that provide few, if any, incentives for organizational collaboration and change. The fact that the most expensive health care system in the world does not provide the healthiest outcomes is a driving force in this exploration. By reflecting on American values and beliefs regarding health care from philosophical, clinical, communication, and cost perspectives, this text is designed to encourage an organizational transformation at every level, from government to providers to patients.
This comprehensive survey is an important guide for those studying, or working in, health care professions, as well as health care policy and administration. It should also be of interest to any reader who seeks to better understand U.S. health care policy from social science, economic, and/or health communication perspectives.
Michael Pagano is an Associate Professor in the Department of Communication at Fairfield University, Connecticut. After serving as an Army corpsman in Vietnam, he became a Physician Assistant-Certified (PA-C). While working in Emergency Departments, he went to graduate school and earned an MA in English and a PhD in Communication with a focus in health communication. Over the past 40 years he has practiced as a PA-C and combined patient care with his passion for teaching and his interest in exploring health communication from consumerprovider, provider education, and health care organizational communication perspectives. Currently, he teaches a wide variety of undergraduate and graduate health, organizational, and interpersonal communication courses, including interdisciplinary health studies courses for health professions students.
UNDERSTANDING HEALTH CARE IN AMERICA
Culture, capitalism, and communication
Michael Pagano
First published 2021 by Routledge 2 Park Square Milton Park Abingdon Oxon - photo 2
First published 2021
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
52 Vanderbilt Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
2021 Michael Pagano
The right of Michael Pagano to be identified as author of this work has been asserted by him in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.
Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
A catalog record for this book has been requested
ISBN: 978-1-138-59292-6 (hbk)
ISBN: 978-1-138-59293-3 (pbk)
ISBN: 978-0-429-48972-3 (ebk)
Typeset in Bembo
by Wearset Ltd, Boldon, Tyne and Wear
This book is dedicated to Canera, who has made our time together the best years of my life. You continue to inspire me and make every day better than the last. You make me laugh and youre the best health care provider and attorney I know!
CONTENTS
I have been asked by students and colleagues, why I am writing this book. It is certainly a valid question that I gave a lot of thought to prior to submitting a proposal and completing this work. I find myself in a rather unique position to examine and explore U.S. health care from a variety of professional, personal, and scholarly perspectives. Having learned about clinical medicine as an 18-year-old Army Medic, first in a classroom for 10 weeks, and then in the jungles of South Vietnam for a yearI found a profession I wanted to immerse myself in once I finished my military service. When I did not get into medical school on my first attempt in 1974, I reflected on my options and, with our first child on the way, I opted to go for a relatively new provider educational program and become a Physician Assistant (PA). Over the next 40 years, I never once regretted that decision and as a PA I have seen health care through the lens of a mid-level provider in rural Oklahoma, suburban Wisconsin and Connecticut Emergency Departments, as well as in surgery, physician-owned primary care practices, Planned Parenthood, and corporate occupational health clinics.
As a result of this diverse career, both full-, part-time, and per diem, I learned not just about caring for people, but about the business of 21st century health care access and delivery. Furthermore, I saw its transformation, as well as the difficulties that emerged for all types of providers, patients, hospital administrators, and U.S. taxpayers. The economic realities for health care providers over the past two to three decades have been truly disruptive for most of the professionals I worked with and observed. In part, as a consequence of these changes and because I enjoyed teaching, I went back to school (while still working as a PA) and earned a doctorate in Communication. It seemed logical at the time to focus on a relatively new area of study, health communication, and for the past 35 years, I have been concurrently, PAing, researching, teaching, and publishing related to health, interpersonal, and organizational communication.
In the last decade of the 20th century, I suddenly had an opportunity to put my unique, PA and PhD experiences and expertise to use in a new career. I took a position with a top-five health care advertising agency in New York City that focused on promotion to prescribers. As a copywriter, I moved up in the organization to become a Senior VP and Assistant Creative Director for Copy, working closely with the Marketing Directors of major pharmaceutical companies, as well as medical device manufacturers.
After 12+ years in health care advertising, I was able to return to the classroom full timeteaching undergraduate and graduate students about health communication, health care organizations, and Americas unique approach to access and delivery. As a result of this multi-focal experienceanalyzing the U.S. system (as a provider, marketer, consumer, and social scientist), I have authored six previous books on health communication, written and/or co-authored dozens of journal articles and conference presentations, as well as taught more than 60 different courses. These diverse professional and scholarly pursuits over the past 40+ years, have provided me with a view of U.S. health care access and delivery that is both historical, personal, and professional.
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