Inescapable Decisions examines the disarray in the American health care system and proposes major corrective strategies. Mechanic shows that the high-technology interventionist type of medicine commonly practiced in the United States has lost its sense of priorities and balance. Expensive and sometimes dangerous procedures of unknown efficacy are used excessively and often inappropriately, while many basic preventive and primary care services remain unavailable to those who need them the most. This incredibly complex system of care operates in an environment of heavy-handed rules and regulations and enormous waste of resources.
Mechanic argues for a transformation of the medical paradigm, including how health affairs are addressed. Strategies for preventing illness and limiting disabilities are needed for both communities and individuals. He maintains that health care costs cannot be brought under control without a budgetary ceiling. Such limitations offer the most realistic, appropriate, and nonintrusive way to allocate services. Mechanic shows that much of the neglect of sick and disadvantaged populations results from an approach to health and welfare issues that encourages fragmentation of services.
The goal of a workable health system is now a national priority. Inescapable Decisions illustrates how to forge a better, more caring system that will be adaptive to future problems, one that brings the disadvantaged into the mainstream of health concerns. This path-breaking book will be of wide interest to health care officials, policymakers, and professionals in social welfare.
Industry Reviews
-Inescapable Decisions is David Mechanic's finest book. If one had to select a single volume to give to a health professional, a policy-maker, or a lay person that represented by social science is essential to health and health care, this collection of essays is that book. . . . No one has put together a more impressive collection of essays about the dangerous complexities in America's health and health care.-
--Arthur Kleinman, M.D., Harvard Medical School
-Splendid. . . . Inescapable Decisions is by far the best book on this critical topic yet to appear.-
--Matilda White Riley, National Institute on Aging, NIH -This is a well-written, well-documented, and provocative volume. It is a more coherent collection than most volumes consisting of previously published work by a single investigator. . . . This is first-rate work by one of the best people in the field.-
--Charles A. Kiesler, Contemporary Sociology "Inescapable Decisions is David Mechanic's finest book. If one had to select a single volume to give to a health professional, a policy-maker, or a lay person that represented by social science is essential to health and health care, this collection of essays is that book. . . . No one has put together a more impressive collection of essays about the dangerous complexities in America's health and health care."
--Arthur Kleinman, M.D., Harvard Medical School
"Splendid. . . . Inescapable Decisions is by far the best book on this critical topic yet to appear."
--Matilda White Riley, National Institute on Aging, NIH "This is a well-written, well-documented, and provocative volume. It is a more coherent collection than most volumes consisting of previously published work by a single investigator. . . . This is first-rate work by one of the best people in the field."
--Charles A. Kiesler, Contemporary Sociology "Inescapable Decisions is David Mechanic's finest book. If one had to select a single volume to give to a health professional, a policy-maker, or a lay person that represented by social science is essential to health and health care, this collection of essays is that book. . . . No one has put together a more impressive collection of essays about the dangerous complexities in America's health and health care."
--Arthur Kleinman, M.D., Harvard Medical School
"Splendid. . . . Inescapable Decisions is by far the best book on this critical topic yet to appear."
--Matilda White Riley, National Institute on Aging, NIH "This is a well-written, well-documented, and provocative volume. It is a more coherent collection than most volumes consisting of previously published work by a single investigator. . . . This is first-rate work by one of the best people in the field."
--Charles A. Kiesler, Contemporary Sociology
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