Health care spending in the United States today is approaching 20 percent of GDP, yet levels of U.S. population health have been declining for decades relative to other wealthy and even some developing nations. How is it possible that the United States, which spends more than any other nation on health care and insurance, now has a population markedly less healthy than those of many other nations? Sociologist and public health expert James S. House analyzes this paradoxical crisis, offering surprising new explanations for how and why the United States has fallen into this trap. In Beyond Obamacare, House shows that health care reforms, including the Affordable Care Act, cannot resolve this crisis because they do not focus on the underlying causes for the nation’s poor health outcomes, which are largely social, economic, environmental, psychological, and behavioral. House demonstrates that the problems of our broken health care and insurance system are interconnected with our large and growing social disparities in education, income, and other conditions of life and work, and calls for a complete reorientation of how we think about health. He concludes that we need to move away from our misguided and almost exclusive focus on biomedical determinants of health, and to place more emphasis on addressing social, economic, and other inequalities. House’s review of the evidence suggests that the landmark Affordable Care Act of 2010, and even universal access to health care, are likely to yield only marginal improvements in population health or in reducing health care expenditures. In order to rein in spending and improve population health, we need to refocus health policy from the supply side—which makes more and presumably better health care available to more citizens—to the demand side—which would improve population health though means other than health care and insurance, thereby reducing need and spending for health care. House shows how policies that provide expanded educational opportunities, more and better jobs and income, reduced racial-ethnic discrimination and segregation, and improved neighborhood quality enhance population health and quality of life as well as help curb health spending. He recommends redirecting funds from inefficient supply-side health care measures toward broader social initiatives focused on education, income support, civil rights, housing and neighborhoods, and other reforms, which can be paid for from savings in expenditures for health care and insurance. A provocative reconceptualization of health in America, Beyond Obamacare looks past partisan debates to show how cost-efficient and effective health policies begin with more comprehensive social policy reforms.
Congress and Its Members has been the gold standard for Congress courses for thirty years. Now in its 19th edition, the book offers comprehensive coverage of the U.S. Congress and the legislative process by examining the tension between Congress as a lawmaking institution and as a collection of politicians constantly seeking re-election. The 19th edition covers the outcomes of the 2022 election and subsequent changes in in congressional organization and leadership, including the protracted battle for the House speakership. The book’s election coverage details regional shifts in party strength, voting behavior, the use of digital media in congressional elections, and state-level efforts to expand and restrict voting access. Up-to-date information on the diversity of the new Congress in terms of race, ethnicity, gender, and professional background is provided. The politics and outcomes of the 2022 primary elections are covered, as well. Always balancing great scholarship with currency, the book features lively case material along with relevant data, charts, maps, and photos.
The fictional story of "Girl & Boy" takes place in a Midwest city in July of 1973. A heroin addict mother and a hot headed father leaves Junior without parents. He moves in with his father's mother. At the age of 17, he learns a lifelong lesson in a few years. With determination to succeed, he does it! With help and support of his girl and a strong willed uncle, he's wealthy before he's thirty years old. However, he has been through hell and back and recognizes love
Killer snowmen... alien girlfriend... zombies... What will they think of next? Creepy mystery writer Brandon James takes on the creepiest cases yet while he's struggling to keep his newfound family --- the Rat Pack together. Meanwhile, new members rise to occasion. Filled with offbeat humor & dark personal drama that makes Volume 2 better than the original.
This new edition of a well-established textbook covers the environmental and engineering aspects of the management of rainwater and wastewater in areas of human development. Urban Drainage deals comprehensively not only with the design of new systems, but also the analysis and upgrading of existing infrastructure. Keeping its balance of principles, practice and research, this new edition has significant new material on modelling, resilience, smart systems, and the global and local context. The two new authors bring further research and practice-based experience. This is an essential text for undergraduate and graduate students, lecturers and researchers in water engineering, environmental engineering, public health engineering, engineering hydrology, and related non-engineering disciplines. It also serves as a dependable reference for drainage engineers in water service providers, local authorities, and for consulting engineers. Extensive examples are used to support and demonstrate the key issues throughout the text.
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