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Beyond the crisis. Preserving the capacity for excellence in health care and medical science
Book
reviews
/ Health
Policy
35 (1996)
95-98
91
Beyond the Crisis. Preservingthe Capacity for Excellencein Health Care and Medical Science H. Greenberg, S. Raymond (Eds.) The New York Academy of Sciences, New York, 198 pp., 1994 ISBN o-89766-901 -0.
This book consists of some two dozen condensed papers, originally delivered at the New York Academy of Sciences symposium held in 1994, before the health care reform of the Clinton administration came to a halt. The possible impact of health care reform on the practice and science of medicine is the main topic, viewed from many sides by US experts. Excellence is seen as the ongoing commitment of the physicians to strive for what is best for his patient. one of the editors, Henry Greenberg from New York, argues there is no new crisis but a host of old problems, mostly related to social inequality in education, poverty and violence. These ills will not be cured by managed care, a streamlined bureaucracy or financial reform. It is feared that new, untried or unevaluated methods of outcome analysis, managed care and the seeking of the lowest cost will damage academic medicine, diminish quality of care and will limit biomedical research. on the other hand, the medical profession is criticised for overprescribing, greed and inappropriate use of new technology. Professional autonomy and social responsibility are often in conflict, without easy solutions. The short but lively presentations give a good impression of American fears and hope as to health care reform. Freedom for the profession, protection against external constraints and regulation, better professional conduct in clinical practice and research should pave the road for excellence without interference. The essential problem of American society, however the unequal distribution of health, wealth, education, housing and employment in a large nation with a patchwork social fabric, will not be solved even by excellent doctors and scientists. Professor Dr. D. Dunning Dutch Journal of Medicine The Netherlands
Books Received The receipt of these books is acknowledged, and this listing must be regarded as sufficient return for the courtesy of the sender. Books that appear of particular interest will be reviewed in the forthcoming issues of Health Policy as space permits.
reviews
/ Health
Policy
35 (1996)
95-98
91
Beyond the Crisis. Preservingthe Capacity for Excellencein Health Care and Medical Science H. Greenberg, S. Raymond (Eds.) The New York Academy of Sciences, New York, 198 pp., 1994 ISBN o-89766-901 -0.
This book consists of some two dozen condensed papers, originally delivered at the New York Academy of Sciences symposium held in 1994, before the health care reform of the Clinton administration came to a halt. The possible impact of health care reform on the practice and science of medicine is the main topic, viewed from many sides by US experts. Excellence is seen as the ongoing commitment of the physicians to strive for what is best for his patient. one of the editors, Henry Greenberg from New York, argues there is no new crisis but a host of old problems, mostly related to social inequality in education, poverty and violence. These ills will not be cured by managed care, a streamlined bureaucracy or financial reform. It is feared that new, untried or unevaluated methods of outcome analysis, managed care and the seeking of the lowest cost will damage academic medicine, diminish quality of care and will limit biomedical research. on the other hand, the medical profession is criticised for overprescribing, greed and inappropriate use of new technology. Professional autonomy and social responsibility are often in conflict, without easy solutions. The short but lively presentations give a good impression of American fears and hope as to health care reform. Freedom for the profession, protection against external constraints and regulation, better professional conduct in clinical practice and research should pave the road for excellence without interference. The essential problem of American society, however the unequal distribution of health, wealth, education, housing and employment in a large nation with a patchwork social fabric, will not be solved even by excellent doctors and scientists. Professor Dr. D. Dunning Dutch Journal of Medicine The Netherlands
Books Received The receipt of these books is acknowledged, and this listing must be regarded as sufficient return for the courtesy of the sender. Books that appear of particular interest will be reviewed in the forthcoming issues of Health Policy as space permits.