Karen Goldsteen (author) - Jonas Introduction to the U.S. Health Care System

i Jonas Introduction to the
U.S. Health Care System

ii Raymond L. Goldsteen, DrPH, MA, is Professor Emeritus of Preventive Medicine at Stony Brook University School of Medicine. He was founding director of the MPH Program and professor of Population Health in the School of Medicine and Health Sciences, University of North Dakota. He was also founding director of the Graduate Program in Public Health and professor of Preventive Medicine in the School of Medicine at Stony Brook University. Dr. Goldsteen has an extensive background in health care and was formerly a director of the health policy research centers at the University of Illinois in Urbana-Champaign, University of Oklahoma College of Public Health, and the West Virginia University School of Medicine. He is a coauthor of Introduction to Public Health, now in its second edition, and many peer-reviewed publications in health and health care.

Karen Goldsteen, PhD, MPH, is an Affiliated Public Health Faculty member in the Program in Public Health at Stony Brook University. Prior to this, she was a research associate professor of Population Health in the MPH Program, School of Medicine and Health Sciences, at the University of North Dakota. She was also a research associate professor of Health Technology and Management in the Graduate Program in Public Health at Stony Brook University. She was awarded her MPH degree from Columbia University School of Public Health and her PhD in Community Health from the University of Illinois at Urbana-Champaign. She was a Pew Health Policy Fellow at the University of California, San Francisco. Dr. Goldsteen is a coauthor of Introduction to Public Health, now in its second edition, and many peer-reviewed publications on health and health care.

Benjamin Z. Goldsteen, MBA, earned his masters degree from Columbia University in New York. He has 20 years of experience as an innovator in health care and life sciences organizations. While working at one of the largest consulting firms in the world, he led multiple strategy and performance-improvement engagements for health care clients across the United States from assessment through implementation. He is highly knowledgeable about all aspects of health care delivery and the policies that impact the health care system. He currently serves as Chief Analytics Officer of a division dedicated to driving transformation across the largest municipal health care system in the United States.

iii Jonas Introduction to the
U.S. Health Care System

Ninth Edition

Raymond L. Goldsteen, DrPH, MA

Karen Goldsteen, PhD, MPH

Benjamin Z. Goldsteen, MBA

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First Springer Publishing edition 1982

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ISBN: 978-0-8261-7402-4

ebook ISBN: 978-0-8261-7404-8

DOI: 10.1891/9780826174048

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Instructors Manual: 978-0-8261-7405-5

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eChapter: The ACA in 2020: An Update: 978-0-8261-7412-3

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Library of Congress Cataloging-in-Publication Data

Names: Goldsteen, Raymond L., author. | Goldsteen, Karen, author. | Goldsteen, Benjamin Z., author.

Title: Jonas introduction to the U.S. health care system / Raymond L. Goldsteen, Karen Goldsteen, Benjamin Z. Goldsteen.

Other titles: Introduction to the U.S. health care system

Description: Ninth edition. | New York : Springer Publishing Company, LLC, 2021. | Includes bibliographical references and index.

Identifiers: LCCN 2020005922 (print) | LCCN 2020005923 (ebook) | ISBN 9780826174024 (paperback) | ISBN 9780826174048 (ebook) | ISBN 9780826174055 (instructors manual) | ISBN 9780826174086 (powerpoints) | ISBN 9780826174079 (test bank)

Subjects: MESH: Delivery of Health Care | Health Services Administration | Insurance, Health | Health Policy | Health Servicestrends | United States

Classification: LCC RA395.A3 (print) | LCC RA395.A3 (ebook) | NLM W 84 AA1 | DDC 362.10973dc23

LC record available at https://lccn.loc.gov/2020005922

LC ebook record available at https://lccn.loc.gov/2020005923

Publishers Note: New and used products purchased from third-party sellers are not guaranteed for quality, authenticity, or access to any included digital components.

Printed in the United States of America.

v This book is dedicated to children and grandchildren everywhere, in hope that they will have access to quality health care in their future. vi

vii Contents

eChapter: The Affordable Care Act in 2020: An Update

xix Preface

This is the ninth edition of An Introduction to the U.S. Health Care System, now titled Jonas Introduction to the U.S. Health Care System. It was our privilege, and indeed an honor, to be asked by Dr. Steven Jonas to coauthor the sixth edition in preparation for assumption of full authorship of subsequent editions.

In the ninth edition, we continue the practice of Drs. Roemer and Jonas, providing both descriptions of and commentary on the health care system. As Dr. Jonas wrote in the Preface to the seventh edition, this book has a political and philosophical point of view. Although it always attempts to be objective, it is not neutral. Its primary social value is that the principal purpose of the U.S. health care delivery system, taking precedence over any other purpose, should be to meet and serve the health care needs of the American people. If other purposes, such as the production of private profit, power, prestige, and political advantage, are achieved at all, they should very much take a back seat to the stated primary purpose.

The ninth edition provides an update of the health care system and its history of change. Two significant developments in the period that has elapsed since the sixth edition in 2007the rise of the Tea Party and the passage of the Affordable Care Act (ACA)encapsulate the conflict within the larger society, which continues to prevent the health care system from fully achieving equity, quality, and efficiencythe criteria used to evaluate all health systems (). The Tea Partys success in rousing public opinion against government ensured that in health care, as in all other areas of society, private-sector interests would be defended even if doing so maintained inequity, inefficiency, and poor quality care. The ACA represents the best efforts of those who believe that government has a responsibility to ensure an equitable, efficient, and quality health care system but who were constrained by antigovernment sentiment and its converse, preference for the private sector.