Hospital city, health care nation : race, capital, and the costs of American health care

Title:

Author:

McKee, Guian A., author.

ISBN:

9781512823936

Personal Author:

McKee, Guian A., author.

Physical Description:

x, 379 pages : illustrations, maps ; 24 cm.

Series:

Politics and culture in modern America

Politics and culture in modern America.

General Note:

Source of cataloging data: WCP

Abstract:

"This book recasts the story of the health care system by emphasizing the economic and social importance of hospitals in American communities. While hospitals have become vital economic anchors in cities across the country, the spending that supports them has constrained possibilities for comprehensive health care reform"-- Provided by publisher.

Contents:

Building the hospital city -- Living with the hospital city -- Costs of the hospital city.

Subject Term:

Medical care, Cost of -- United States.

Medical policy -- Economic aspects -- United States.

Urban hospitals -- Economic aspects -- United States.

Urban hospitals -- Social aspects -- United States.

Health care reform -- United States.

Racism in medicine -- United States.

Racism in medicine.

Medical care, Cost of.

Health care reform.

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Library	Material Type	Call Number	Status	Item Holds
Searching... Sugar Grove - Todd Library	Book	RA410.53 .M386 2023	Searching... Unknown	Searching... Unavailable

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Summary

Hospital City, Health Care Nation recasts the story of the U.S. health care system by emphasizing its economic, social, and medical importance in American communities. Focusing on urban hospitals and academic medical centers, the book argues that the country's high level of health care spending has allowed such institutions to become vital, if often problematic, economic anchors for communities. Yet that spending has also constrained possibilities for comprehensive health care reform over many decades, even after the passage of the Affordable Care Act in 2010. At the same time, the role of hospitals in urban renewal, in community health provision, and as employers of low-wage workers has contributed directly to racial health disparities.
Guian A. McKee explores these issues through a detailed historical case study of Baltimore's Johns Hopkins Hospital while also tracing their connections across governmental scales--local, state, and federal. He shows that health care spending and its consequences, rather than insurance coverage alone, are core issues in the decades-long struggle over the American health care system. In particular, Hospital City, Health Care Nation points to the increased role of financial capital after the 1960s in shaping not only hospital growth but also the underlying character of these vital institutions. The book shows how hospitals' quest for capital has interacted with structural racism and inequality to shape and constrain the U.S. health care system. Building on this reassessment of the hospital system, its politics, and its financing, Hospital City, Health Care Nation offers ideas for the next steps in health care reform.

Reviews (2)

Choice Review

Centered on Baltimore's Johns Hopkins Hospital system, this panoramic and carefully structured political and socioeconomic study investigates and analyzes the complex dynamics of health care reform that arose in a racially and economically segregated metropolis across the last five tumultuous decades of the 20th century. As medical science and practice advanced, the cost of health care skyrocketed. Over time, a complex and ever-shifting cast of community leaders, local and national politicians, health care professionals, hospital workers, and economists laboriously--and often contentiously--reshaped the city and its health care system. McKee, a professor of presidential studies at the University of Virginia, takes care to name each one of the multitude of individuals depicted--local, state, and national--along with their varying roles and agendas, making what might have been a ponderous academic work a meticulously researched, clearly written, and highly accessible narrative. As McKee observes, unresolved challenges remain and health care will, by its nature, always be a work in progress. Summing Up: Highly recommended. Upper-division undergraduates. Graduate students, faculty, and professionals. General readers. --Sandra W. Moss, independent scholar

Library Journal Review

McKee (presidential studies, Univ. of Virginia; The Problem of Jobs) links urban hospitals, academic medical centers, health care spending, and community economics to urban renewal, community health initiatives, racial health disparities, and constraints on reform. The author uses the phrase "hospital city" to describe the health care industry's seizing of multiple facets of community life, such as providing jobs and social services. Citing John Hopkins Hospital as his case study, the author argues that health care spending, insurance, and growth are all equally responsible for the industry's issues. Recognizing the need for reform, McKee acknowledges that the United States' free-market approach leads to competition between the major hospitals and health care systems, causing them to expand by establishing facilities and clinics locally and internationally. The book's endnotes are heavy with government documents that provide useful resources ranging from the 1950s to 2021, and its 11 chapters include a few black-and-white illustrations and easily identified acronyms, plus a glossary of acronyms. Similar titles focus on specific problems, such as racial disparities in health care and reform, while this book touches on all areas. VERDICT Will likely appeal to graduate students, professionals, and think tanks interested in all aspects of the health care system.--Laurie Selwyn

Abbreviations Used in Text	ix
Introduction. Crisis in the Hospital City-and the Health Care Nation	1
Part I Building the Hospital City
1 The Public Foundations of the Hospital City	15
2 Urban Renewal in the Hospital City	30
3 Medicare, Hospitals, and "the Gold at Fort Knox"	61
4 Johns Hopkins in the Hospital Metropolis	82
Part II Living with the Hospital City
5 The Hospital City and the National Health Insurance Struggle	111
6 Wages, Jobs, and Cost in the Hospital City	127
7 Hospital Cost Control in Maryland	149
8 To Stay or Go, and How to Pay for It	164
Part III Costs of the Hospital City
9 "The Dream Shall Never Die" … but It May Be Compromised	193
10 "A New Emphasis on Market Strategies"	223
11 Markets, Medicaid, and Mergers	249
Conclusion. Reform in the Hospital City-and the Health Care Nation	271
Abbreviations Used in Notes	287
Notes	293
Index	353
Acknowledgments	377

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Bound With These Titles

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Summary

Summary

Reviews (2)

Choice Review

Library Journal Review

Table of Contents