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Poverty and the Myths of Health Care Reform, by Richard (Buz) Cooper
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In Poverty and the Myths of Health Care Reform, Dr. Richard (Buz) Cooper argues that US poverty and high health care spending are inextricably entwined. Our nation’s health care system bears a financial burden that is greater than in any other developed country in large part because impoverished patients use more health care, driving up costs across the board.
Drawing on decades of research, Dr. Cooper illuminates the geographic patterns of poverty, wealth, and health care utilization that exist across neighborhoods, regions, and states―and between countries. He chronicles the historical threads that have led to such differences, examines the approaches that have been taken to combat poverty throughout US history, and analyzes the impact that structural changes now envisioned for clinical practice are likely to have. His research reveals that ignoring the impact of low income on health care utilization while blaming rising costs on waste, inefficiency, and unnecessary care has led policy makers to reshape clinical practice in ways that impede providers who care for the poor.
The first book to address the fundamental nexus that binds poverty and income inequality to soaring health care utilization and spending, Poverty and the Myths of Health Care Reform is a must-read for medical professionals, public health scholars, politicians, and anyone concerned with the heavy burden of inequality on the health of Americans.
- Sales Rank: #196455 in Books
- Brand: imusti
- Published on: 2016-07-08
- Original language: English
- Dimensions: 9.00" h x .99" w x 6.00" l,
- Binding: Hardcover
- 304 pages
- Johns Hopkins University Press
Review
An extremely important, brilliantly told story that, if understood by more people, would bring major changes to our health care system by improving medical care and reducing costs.
(Michael M.E. Johns, MD, President, CEO, and Chairman of the Board, Emory Healthcare)Cooper makes the centrally important argument that socioeconomic factors underlie high health care utilizations and costs, leaving people living in poverty vulnerable to poor health, high levels of hospitalization and readmission, and limited life prospects. Approaching the problem from multiple angles, this book is an important contribution to policy, scholarship, and the lives and livelihoods of Americans.
(Carol Underwood, Johns Hopkins Bloomberg School of Public Health)The great virtue of this compelling book about the problems of the American healthcare system is its relentless focus on one root cause that is external to that system: poverty and the unequal distribution of income and wealth. Throughout our history we see that the poor are likelier to be sick, the sick are likelier to be poor, and, without intervention, the poor inevitably grow sicker and the sick inevitably grow poorer. These truths distort healthcare access, costs, and quality. While others argue that poverty is not the only cause of our healthcare problems, Cooper argues that no solution that ignores poverty will work.
(H. Jack Geiger, MD, The City University of New York Medical School)Cooper has laid out with strong science and impassioned eloquence the profound influence of poverty and its social consequences on the utilization of health care services. Every clinician will benefit from reading this book in order to provide―and advocate for―the scope of interventions necessary for effective care.
(Mary O. Mundinger, DrPh, Columbia University)Experts say that there are two main problems with the American health care system: the care is ineffective and expensive, and not everyone has equal access to it. This important book breaks this logical contradiction. This intricate analysis shows that the problem is poverty, not inefficiency.
(Mark V. Pauly, The Wharton School of the University of Pennsylvania)From a ride through New York's crazy quilt of neighborhoods, to a tour of Milwaukee's poverty corridor, to the skillful shredding of academic studies, Buz Cooper makes a compelling case that high health care costs and poverty are inextricably linked. Poverty and the Myths of Health Care Reform is both accessible and authoritative.
(Lillian Thomas, Pittsburgh Post-Gazette, producer of "Poor Health")A highly sophisticated and powerful analysis of the relationship that exists between poverty and the aggregate cost of health care in this country, this book stands alone in explaining the relationship that exists between the level of poverty and the inexorable rise in health care costs. The book should be required reading.
(Michael Whitcomb, MD, former Senior Vice President, Association of American Medical Colleges (AAMC))The book contains a comprehensive reference list. It also offers helpful information for every American interested in improving the country’s health care system. Recommended.
(Choice)... passionately but meticulously argured...
(Penn Medicine) About the Author
Richard (Buz) Cooper, MD (1936–2016), was a senior fellow at the University of Pennsylvania’s Leonard Davis Institute of Health Economics, the dean and executive vice president of the Medical College of Wisconsin, where he founded the Institute for Health and Society, and the cofounder and director of the University of Pennsylvania Cancer Center.
Most helpful customer reviews
1 of 1 people found the following review helpful.
Half true
By Charles Homer
This book does an excellent job describing how poverty and all that goes with it is far and away the strongest driver or health status. It also clearly shows how the relatively low health ranking of the US can be attributed to our substantial underinvestment in social services and income support compared with peer nations. These same patterns hold true across the US as well. This aspect of the book is Well done and well said and his personal experiences inform these points well.
Where the book goes awry is pursuing a vendetta against the researchers who identified substantial variation in care across the US. Those researchers, acknowledging that poverty drives many health outcomes, nonetheless find that variation persists even when poverty status is held constant. The author challenges these findings but we are hearing and reading only one side of the argument. The author contends that this focus on unwarranted and unexplained variation has led to burdensome overregulation of the practice of medicine, which appears to be his main concern, and also explains America's failure to address poverty.
The author fails to examine the well documented gaps in quality of health care, even if these are no worse than in other countries (e.g., meeting only half of recommended practices). Similarly he does not address why an appeal to professionalism alone did not motivate significant engagement by the physician community in addressing quality gaps (acknowledging that current approaches are indeed too burdensome and 'pay for performance' has predictable adverse effects).
More fundamentally, America's reluctance to seriously address poverty or focus on tackling inequality as a health strategy has a longer provenance and deeper causes than the recent focus on quality and value in health care services. Tackling those barriers is a more worthy target.
0 of 0 people found the following review helpful.
This is the start of an important health care policy conversation...
By Neecy
It's easy to ignore things you can't quantify, but the late Dr. Cooper provides a great analysis of the link between poverty, income inequality and health care spending (costs). He knew he had to meet his opposition on their turf, quantitative analysis, and despite their resources and conscious approach to limit their studies to known quantities, his argument is as persuasive as theirs, if not more so.
If I have any complaints about the book it is that it makes the same points over and over--a little repetition is a good thing, but there is a lot of repeating of the facts. Also, it is too pro-medical establishment and he makes doctors look saintly. Dr. Cooper also gives lip-service to the high medical prices unique to the U.S., and he is quick to dismiss medical care quality improvement efforts which are still needed. But in his defense his focus was on poverty, and he makes a very convincing argument.
Everyone needs to read this book and consider its premise.
0 of 0 people found the following review helpful.
Truth manifesto on illegitimacy of Healthcare Reform's Cobbled Assembly
By Ryan G.
Dr. Cooper should've been consulted by Barry, before he died!
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