This revised edition of Arnold Birenbaum's important book brings the work up to date through the end of 1994 and the close of the 103rd Congress. It offers a comprehensive, provocative, and completely new assessment of health care reform with a focus on financing and coverage. A fine primer.on the health care debate (JAMA), the book examines such topics as the changing doctor-patient relationship, the growth of managed care, the rise and decline of hospitals, American business and health benefits, and the uninsured in America. This new edition takes particular heed to the failure of health care reform in 1994.In responding to the first edition, Victor Sidel, M.D., former president of the American Public Health Association, called it, "A wonderfully far-ranging, meticulously documented, insightfully analyzed and remarkably well written challenge to professionals, patients, and community members to work for effective change in a bizarre, expensive, inefficient, and often unresponsive medical care system."

PrefaceIntroductionA System in Need of DirectionDissatisfaction Widespread--Our Leaders Receive a Wake-Up CallThe Changing Relationship with Your DoctorThe Growth of Managed Care and the BacklashThe Challenge to ProvidersThe Rise and Decline of HospitalsAmerican Business and Health BenefitsThe Uninsured, the Uninsurable, and the Fear of FallingCurrent NeedsVulnerable PeopleLong-Term CarePeople with AIDSThe Right to DieCaring for the FutureNorthern Exposure: The Canadian ExperimentTaking Health Care Off the National Agenda--The Failure to Answer the Wake-Up CallReferencesIndex