The American Health Care Paradox

September 23, 2013
Bradley, faculty director of Yale University’s Global Health Leadership Institute, and Taylor, the institute’s former program manager, contrast American healthcare models with the much more successful models in Denmark, Norway, and Sweden. The Scandinavian model, a dramatically more holistic approach envisioning citizen health as inextricably linked to national welfare, views greater spending on housing, education, employment, and nutrition as necessary components of healthcare outcomes, resulting in less overall spending with far greater results. The authors assemble an expansive study of representatives from the health-care and social sectors, including hospital administrators, social workers, physicians, police, emergency service personnel, nurses, educators, and pharmacists to demonstrate the need for integration between medicine and social welfare in the U.S. The disconnect between social services and health care, and the deeper historical schism between public and private interests, emerges as the reason why the U.S., which ranks first in healthcare spending, is mired in disappointing health outcomes. Admirably presented as an apolitical examination of an urgent situation, Bradley and Taylor’s carefully researched and lucidly reported findings, including innovative approaches in Connecticut, Oregon, and California, offer what appears to be an easily rendered fix, but their equally striking depiction of uniquely American hostility to government involvement in private matters, exposes a daunting uphill battle.

December 1, 2013

Bradley (public health, Yale Univ.) and Taylor (former program manager, Yale Global Health Leadership Inst.) take a fresh look at the reasons why Americans pay more for health care and yet are not as healthy as residents of other industrialized nations, specifically Scandinavian countries. The authors interviewed more than 80 health policy specialists and consumers to help formulate their theories. A key factor is the amount of money other countries spend on social services, treating not just a patient's physical needs but the whole person. The authors consider many factors, such as the necessity for professional collaboration, beliefs in the causes of illness, views on self-reliance, the Scandinavian emphasis on the collective--rather than the individual--good, and the role of government in a democracy. They offer encouragement to programs that have improved the health of individuals in selected American neighborhoods and suggest ways to expand these programs. The Affordable Care Act, aka Obamacare, focuses mainly on providing health care to those previously uninsured, but the authors state that it will most likely not address the root cause of the paradox. While there are many contemporary titles about health care, there is little information available in book format about this specific conundrum. Chapter notes are also included, from professional journals, books, and governmental websites. VERDICT This remarkably well-written, lucid work is highly appropriate for public and academic libraries.--Martha Stone, Treadwell Lib., Boston

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