Foreword to the Sixth Edition
Preface to the Sixth Edition
Abbreviations

1. Introduction

Health and Health Care
Health Care Systems
U.S. Health Care System
Future of the U.S. Health Care System
References

2. Health Care Workforce

Overview
Physicians
Nursing
Physicians Assistants
Health Care Workforce Outside the Hospital and Physician Office
Conclusion
References

3. Hospitals and Other Health Care Institutions

Introduction
SOME NUMBERS
Hospital Structure
Public General Hospitals
The Hospital in the Present Era
Long-Term Care: The Example of Nursing Homes
References

4. Primary and Ambulatory Care

Primary Care
Ambulatory Care
Conclusions
References

5. Government and the Health Care System

Introduction
Some History
The Constitutional Basis of Government Authority in Health Care
The Health Care Functions of Government
The Federal Government and the Provision of Health Services
State Governments' Role in Health Services
Local Governments' Role in Health Services
Problems in Public Health
Conclusions
References

6. Financing and Payment of Health Care

Introduction
How Much is Spent
Where the Money Comes From, Within the System
Where the Money Goes
How the Money is Paid Out: Providers, Payers, and Payments
Conclusions
References

7. Health Care System Performance

Introduction
Quality of Health Care
Equity of Health Care
Efficiency of Health Care
A National Scorecard
Data and Information Technology
Conclusion
References

8. From Prepaid Group Medical Practice to Managed Care

Introduction
Medical Group Practice
Health Maintenance Organizations
Managed Care
Integrated Delivery Systems
Managed Care Today
Some Policy Issues in Managed Care
References

9. Health Care Reform

Introduction
History of Change
National Health Insurance (NHI)
Some Contemporary Approaches to NHI
Looking Ahead
References
Epilogue
Appendix I List of Critical Reports
Appendix II Sources of Data
Appendix III Glossary of Terms

Steven Jonas, MD, MPH, MS, is Professor of Preventive Medicine, School of Medicine, and Professor, Graduate Program in Public Health, at Stony Brook University (NY). He is a Fellow of the New York Academy of Sciences, the American College of Preventive Medicine, the New York Academy of Medicine, and the American Public Health Association. In 2006, he received the Duncan Clark Award for lifetime achievement granted by the Association for Prevention Teaching and Research (formerly the Association of Teachers of Preventive Medicine). He is Editor-in-Chief of the American Medical Athletics Association Journal and a member of the Editorial Board of ACSM's Health and Fitness Journal.

Over the course of an academic career that began in 1969, his research has focused on health care delivery systems analysis, preventive medicine and public health, and personal health and wellness. He has authored, co-authored, edited, and co-edited over 25 books, and published more than 135 papers in scientific journals, as well as numerous articles in the popular literature. He is and has been a regular columnist for a number of scientific and lay publications in the health and health-related arenas and also publishes regularly on several webmagazines on the subject of politics. It was in the mid-70s that, having been given the opportunity to do so by Dr. Ursula Springer, he created Health Care Delivery in the United States. He was actively involved with the first seven editions of that book. He is very proud that his name will be continue to associated down through time with that book, as it will be with this one, as it moves on to future editions under the able stewardship of the Drs. Goldsteen.

Raymond L. Goldsteen, DrPH, is the founding Director of the Graduate Program in Public Health and Professor of Preventive Medicine in the School of Medicine at the State University of New York at Stony Brook. He received his bachelor's degree in urban studies from Columbia University, Master's degree from Brown University in sociology, and doctoral degree from the Columbia University School of Public Health. He has an extensive background in the study of the U.S. health care system through his scholarly work, teaching, and service during his professional career as a university professor and director of health policy research centers at the University of Illinois in Urbana-Champaign, University of Oklahoma College of Public Health, and the West Virginia University School of Medicine.

He is particularly interested in public policy related to vulnerable populations and: 1) investigating the structural and situational factors that improve or maintain the health status of vulnerable populations; 2) determining the factors that lead to public support for policies that improve or maintain population health; and 3) providing information to vulnerable populations that they can use in their own behalf as a development tool. His scholarly work integrates elements of sociology, social psychology, and political science and relates them to the health and well-being of populations.

Karen Goldsteen, PhD, is a faculty member in the Graduate Program in Public Health at the State University of New York at Stony Brook. She received a MPH degree from the School of Public Health at Columbia University and a PhD in Community Health from the University of Illinois at Urbana-Champaign. She was a Pew Health Policy Fellow at the University of California, San Francisco. She has extensive training and experience in research methods related to clinical outcomes research and health services research. She has extensive experience in survey research design and analysis as well as the analysis of large, administrative data bases such as Medicaid claims data and hospital discharge data. She has contributed to a number of major community health research projects focusing on underserved populations. She has completed numerous research projects including utilization of health and social services among the elderly; bypass of rural hospitals for mental health care; lack of insurance coverage and its health consequences; and satisfaction with physicians.