Beyond Crisis (Meridian)

Presents the issues dominating the national debate on health care, from "emergency room gridlock" to "pay or play," in an anthology of essays offering policy suggestions and options for reform

This plump, sometimes unwieldy collection is the product of the Health Policy Advisory Center (Health/PAC), which for more than 25 years has offered solid progressive criticism of what it terms the "medical-industrial complex." Many of the nearly 60 essays collected here first appeared in the Health/PAC bulletin; while many are insightful, some are dated--like a book review that is the main entry on abortion and that predates the current legislative controversy on the subject--and others could use greater contextualization. Diligent readers, however, will find essays detailing a system gone wrong: the fate of underserved communities, such as the Mississippi Delta; the demise of Philadelphia General Hospital, a once prestigious public hospital; the effect of "corporatization" on doctoring; the way women's health centers primarily target the affluent. The last section includes analyses of precursors to President Clinton's health-care proposal; an essay about that plan was not available to PW. McKenzie, Health/PAC's executive director, edited The AIDS Reader.
Copyright 1993 Reed Business Information, Inc.

This compilation of essays by the Health Policy Advisory Center (Health/PAC) covers numerous aspects of U.S. healthcare. Its topics include the current state of the healthcare system, healthcare providers, community responses, and specific health policy prescriptions. This volume is stern in its indictment of the system and reform efforts to date. In her foreword, Barbara Ehrenreich states that Health/PAC's solution is "conceptually simple and politically daunting: Take the profit out of health care." The book's criticisms are comprehensive, and its broad reproach of market approaches to healthcare is bound to generate much discussion among students of healthcare reform. Whatever one's own perspective, Beyond Crisis raises important questions that will eventually have to be answered by policymakers before comprehensive and thoughtful reform can be implemented.
- Karen A. Wolin, Univ. of Illinois at Chicago, Coll. of Medicine
Copyright 1994 Reed Business Information, Inc.

The Health Policy Advisory Center (Health/PAC) has been known for its critique of the "medical/industrial complex" and for its advocacy of grass-roots organizing around health-care issues. In Beyond Crisis, Health/PAC's executive director gathers essays to powerfully indict a health system whose primary goal is not to provide care, but to generate profit. Beyond the health-care cost and access crises, McKenzie's introduction urges, the profit-oriented U.S. health-care system, strengthened by the Social Darwinist Reagan-Bush vision, also faces crises of equity, public health, and democracy. This weighty, heavily documented tome addresses the special health problems of "communities at risk" and the financial problems of caregivers who serve these communities, changes in the structure of the "medical/industrial complex," reforms some medical consumers and professionals have managed to win, principles that could form a basis for a sounder, more democratic health-care system, and proposals for a national health-care agenda. Full of charts, graphs, statistics, and other useful information, but could be better organized. Mary Carroll