HEALTH OF NATIONS: An International Perspective on U.S. Health Care Reform.
Subject: Health planning (Planning)
Health care industry (Planning)
Author: Constable, Joseph F.
Pub Date: 03/01/2000
Publication: Name: Journal of Healthcare Management Publisher: American College of Healthcare Executives Audience: Trade Format: Magazine/Journal Subject: Business; Health care industry Copyright: COPYRIGHT 2000 American College of Healthcare Executives ISSN: 1096-9012
Issue: Date: March, 2000 Source Volume: 45 Source Issue: 2
Product: Product Code: 8000100 Health Care; 8000310 Health Planning NAICS Code: 62 Health Care and Social Assistance SIC Code: 8000 HEALTH SERVICES
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 61822962
Full Text: HEALTH OF NATIONS: An International Perspective on U.S. Health Care Reform, ed. 3

Laurene A. Graig; 1999, 200 pp., Congressional Quarterly Books

In this third edition of the Health of Nations, Laurene Graig reveals how six industrialized nations with significantly different cultural backgrounds and value systems are struggling to provide efficient and effective healthcare for their citizens. Specifically, Ms. Graig attempts to provide the reader with a global perspective of healthcare systems by drawing samples from North America (United States and Canada), Asia (Japan), and Europe (Germany, the Netherlands, and the United Kingdom).

Ms. Graig sets the stage in the first chapter by defining three models: national health service, social insurance, and private insurance. Throughout the text she explains which model or models best describe one or more of the six nations in her study. She uses a continuum, borrowed from Odin Anderson, to classify each system and to assist the reader in understanding the way each nation organizes and finances the delivery of healthcare. At one extreme end of the continuum are the "market-maximized" systems, more closely aligned with the United States's system.

In chapters two through seven, Graig provides the history of the development and current status of healthcare delivery systems in the six nations. She examines their historical development and the manner in which they organize, finance, and deliver healthcare to the different segments of their populations; compares the weaknesses and strengths of each system; and discusses the distinguishing features and the similarities between them. Bar graphs, pie charts, and time lines are used throughout the text to illustrate and aid the presentation.

In the final chapter, the author describes how the United States is unique in the manner in which it delivers healthcare to its citizens and how all of the systems converge. The conclusion is that no system is "pure"--no system is completely competitive, free-market, or regulatory. Rather, a combination is involved in varying degrees in all of the systems examined in this study. The major problems confronting all six nations are aging populations and the increasing costs in delivering effective healthcare to their citizens.

In her final comments, Ms. Graig states that Americans, unlike the citizens of other nations in her study, are ambivalent as to whether they view healthcare as a right or a privilege. Until it comes to a consensus, the United States will probably continue to struggle with the delivery of healthcare and services to its citizens.

I would recommend this book as a supplemental text for graduate or undergraduate students pursuing careers in the field of health administration. I have no major criticisms of the book except that it left me wanting more. Perhaps to have added Russia and China to the nations studied would have filled the void. As an educator and administrator, I found this book to be well-organized, informative, and clear and concise in its presentation. As an aging citizen, I found the information provided to be interesting but somewhat disconcerting due to the numerous and various problems faced by the United States and the other nations highlighted in Ms. Graig's studies. My congratulations to her for continued excellence in writing about the health of nations.

Joseph F. Constable, Ph.D., FACHE Dean, School of Business Robert Morris College
Gale Copyright: Copyright 2000 Gale, Cengage Learning. All rights reserved.