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On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act into law, providing every American with the opportunity to have guaranteed health care coverage. The Affordable Care Act-frequently referred to as Obamacare-is almost synonymous with Obama's presidential legacy and reflects a series of key decisions that he made beginning before he took office. As Meena Bose shows, it was Obama's particular brand of pragmatic politics that ultimately shaped the passage of the Affordable Care Act and made a lasting mark on health care reform in the United States. Pragmatic Vision examines eight of Obama's decisions that resulted in the landmark enactment of health care reform, starting with his commitment to health care reform in the 2008 presidential campaign and concluding with his decision to allow for flexibility with its implementation, following technical hurdles and Supreme Court rulings. Bose shows that Obama's steadfast commitment to the issue was crucial to its passing, especially after the Democrats lost their filibuster-proof majority in the Senate. Obama's direct engagement built key political support for the legislation and was aided by the senior White House staff and Democratic leaders in Congress who skillfully navigated the bill to passage just fourteen months after Obama took office. The story of Obama's leadership in enacting the Affordable Care Act is a tale of today's partisan divide and the polarization of Congress. The legislation passed on a party-line vote and continued to divide politicians long after its passage. Nevertheless, despite repeated efforts by Republicans to repeal the law, it is more popular today than ever and seems destined to remain in force until the next stage of reform. Pragmatic Vision is an authoritative guide to this singular achievement of the Obama administration.

The history, philosophy, ethics, and science behind the placebo and nocebo effects.Placebos are the most widely used treatments in the history of medicine. Thousands of studies show that they can be effective and make us happier and healthier. Yet confusion about what placebos are and how to measure their effects prevents some doctors from using them to help patients. Meanwhile, damage caused by the nocebo effect—the negative effect of expecting something bad—is not widely recognized.In The Power of Placebos, Jeremy Howick provides an interdisciplinary perspective on placebos and nocebos based on more than twenty years of research and data from over 300,000 patients. This book, the culmination of that research, offers practical ways for researchers, policymakers, and doctors to put placebo and nocebo research into practice to improve health outcomes. In addition to providing an overview of placebos and nocebos and explaining how belief systems and context can create physiological effects in the body, Howick advocates for a number of controversial positions, including why it may be unethical to include placebos in most clinical trials in which there are already established therapies and why physicians should consider using placebos regularly in their practices. Howick also underscores the importance of the therapeutic effects of interactions between health care practitioners and patients, in the context of care. The Power of Placebos dispels the confusion surrounding placebos and paves the way for doctors to help patients by enhancing placebo effects and avoiding the pitfalls of nocebos.

In The Battle for Veterans' Healthcare, award-winning author Suzanne Gordon takes us to the front lines of federal policymaking and healthcare delivery, as it affects eight million Americans whose military service makes them eligible for Veterans Health Administration (VHA) coverage. Gordon's collected dispatches provide insight and information too often missing from mainstream media reporting on the VHA and from Capitol Hill debates about its future. Drawing on interviews with veterans and their families, VHA staff and administrators, health care policy experts and Congressional decision makers, Gordon describes a federal agency under siege that nevertheless accomplishes its difficult mission of serving men and women injured, in myriad ways, while on active duty. The Battle for Veterans' Healthcare is an essential primer on VHA care and a call to action by veterans, their advocacy organizations, and political allies. Without lobbying efforts and broader public understanding of what's at stake, a system now functioning far better than most private hospital systems may end up looking more like them, to the detriment of patients and providers alike.

How digital therapies can transform your health.Traditional health care has a new ally. Some patients with sleep disorders, back pain, and diabetes are now being prescribed app-based treatment instead of drugs. Algorithms are helping cancer patients manage their symptoms, and video games are improving the attention span of children diagnosed with ADHD. A new class of medicine called digital therapeutics (DTx) is gaining traction and transforming the way patients engage with the health care system. In Medicine without Meds, Dean Ho, Yoann Sapanel, and Agata Blasiak explore the exciting potential for these digital therapies to transform patient care.Ho, Sapanel, and Blasiak share their insights on how these therapies can deliver value beyond the technology, address the challenges of implementation in existing health care models, and revolutionize care delivery. These clinicians, researchers, engineers, patients, start-up founders, and corporate executives are at the forefront of designing and building tomorrow's DTx. They explain what DTx represents, how it differs from other digital health solutions, and how these tools can be conceptualized, created, and brought to market. Throughout, case studies from leading DTx organization such as Akili Interactive, MedRhythms, and Welldoc illuminate best practices in product development, issues to consider, and pitfalls to avoid. These essays, along with a foreword by D. A. Wallach and Dr. Eddie Martucci's outlook on the future of DTx, present the exciting potential for DTx to reimagine health care for all.

One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands.

Starting with more general issues of healthcare policy and governance in a global perspective and using the lens of national case studies of healthcare reform, this handbook addresses key themes in the debates over changing healthcare policy.

The United States spends greatly more per person on health care than any other country but the evidence shows that care is often poor and inappropriate. Despite expenditures of 1.7 trillion dollars in 2003, and growing substantially each year, services remain fragmented and poorly coordinated, and more than 46 million people are uninsured. Why can't America, with its vast array of resources, sophisticated technologies, superior medical research and educational institutions, and talented health care professionals, produce higher quality care and better outcomes?In The Truth about Health Care, David Mechanic explains how health care in America has evolved in ways that favor a myriad of economic, professional, and political interests over those of patients. While money has always had a place in medical care, \"big money\" and the quest for profits has become dominant, making meaningful reforms difficult to achieve. Mechanic acknowledges that railing against these influences, which are here to stay, can achieve only so much. Instead, he asks whether it is possible to convert what is best about health care in America into a well functioning system that better serves the entire population.Bringing decades of experience as an active health policy participant, researcher, teacher, and consultant to the public and private sectors, Mechanic examines the strengths and weaknesses of our system and how it has evolved. He pays special attention to areas often neglected in policy discussions, such as the loss of public trust in medicine, the tragic state of long-term care, and the relationship of mental health to health care.For anyone who has been frustrated by uncoordinated health networks, insurance denials, and other obstacles to obtaining appropriate care, this book will provide a refreshing and frank look at the system's current and future dilemmas. Mechanic's thoughtful roadmap describes how health plans, healthcare professionals, policymakers, and consumer groups can work together to improve access, quality, fairness, and health outcomes in America.About the Author:

Global Health for All trains a critical lens on global health to share the stories that global health’s practices and logics tell about 20th and 21st century configurations of science and power. An ethnography on multiple scales, the book focuses on global health’s key epistemic and therapeutic practices like localization, measurement, triage, markets, technology, care, and regulation. Its roving approach traverses policy centers, sites of intervention, and innumerable spaces in between to consider what happens when globalized logics, circulations, and actors work to imagine, modify, and manage health. By resting in these in-between places, Global Health for All simultaneously examines global health as a coherent system and as a dynamic, unpredictable collection of modular parts.

The aftermath of Hurricane Katrina has placed a national spotlight on the shameful state of healthcare for America's poor. In the face of this highly publicized disaster, public health experts are more concerned than ever about persistent disparities that result from income and race.This book tells the story of one groundbreaking approach to medicine that attacks the problem by focusing on the wellness of whole neighborhoods. Since their creation during the 1960s, community health centers have served the needs of the poor in the tenements of New York, the colonias of Texas, the working class neighborhoods of Boston, and the dirt farms of the South. As products of the civil rights movement, the early centers provided not only primary and preventive care, but also social and environmental services, economic development, and empowerment.Bonnie Lefkowitz-herself a veteran of community health administration-explores the program's unlikely transformation from a small and beleaguered demonstration effort to a network of close to a thousand modern health care organizations serving nearly 15 million people. In a series of personal accounts and interviews with national leaders and dozens of health care workers, patients, and activists in five communities across the United States, she shows how health centers have endured despite cynicism and inertia, the vagaries of politics, and ongoing discrimination.