How elites shape the use of force in American foreign policy One of the most widely held views of democratic leaders is that they are cautious about using military force because voters can hold them accountable, ultimately making democracies more peaceful. How, then, are leaders able to wage war in the face of popular opposition, or end conflicts when the public still supports them? The Insiders’ Game sheds light on this enduring puzzle, arguing that the primary constraints on decisions about war and peace come from elites, not the public. Elizabeth Saunders focuses on three groups of elites—presidential advisers, legislators, and military officials—to show how the dynamics of this insiders’ game are key to understanding the use of force in American foreign policy. She explores how elite preferences differ from those of ordinary voters, and how leaders must bargain with elites to secure their support for war. Saunders provides insights into why leaders start and prolong conflicts the public does not want, but also demonstrates how elites can force leaders to change course and end wars. Tracing presidential decisions about the use of force from the Cold War through the wars in Iraq and Afghanistan, Saunders reveals how the elite politics of war are a central feature of democracy. The Insiders’ Game shifts the focus of democratic accountability from the voting booth to the halls of power.
NEW YORK TIMES BESTSELLER • “One of our most inventive purveyors of the form returns with pitch-perfect, genre-bending stories that stare into the abyss of our national character. . . . An exquisite work from a writer whose reach is galactic.”—Oprah Daily Booker Prize winner George Saunders returns with his first collection of short stories since the New York Times bestseller Tenth of December. ONE OF THE BEST BOOKS OF THE YEAR: The New York Times Book Review, The New Yorker, Oprah Daily, NPR, Time, USA Today, The Guardian, Esquire, Kirkus Reviews, Booklist, Library Journal The “best short-story writer in English” (Time) is back with a masterful collection that explores ideas of power, ethics, and justice and cuts to the very heart of what it means to live in community with our fellow humans. With his trademark prose—wickedly funny, unsentimental, and exquisitely tuned—Saunders continues to challenge and surprise: Here is a collection of prismatic, resonant stories that encompass joy and despair, oppression and revolution, bizarre fantasy and brutal reality. “Love Letter” is a tender missive from grandfather to grandson, in the midst of a dystopian political situation in the (not too distant, all too believable) future, that reminds us of our obligations to our ideals, ourselves, and one another. “Ghoul” is set in a Hell-themed section of an underground amusement park in Colorado and follows the exploits of a lonely, morally complex character named Brian, who comes to question everything he takes for granted about his reality. In “Mother’s Day,” two women who loved the same man come to an existential reckoning in the middle of a hailstorm. In “Elliott Spencer,” our eighty-nine-year-old protagonist finds himself brainwashed, his memory “scraped”—a victim of a scheme in which poor, vulnerable people are reprogrammed and deployed as political protesters. And “My House”—in a mere seven pages—comes to terms with the haunting nature of unfulfilled dreams and the inevitability of decay. Together, these nine subversive, profound, and essential stories coalesce into a case for viewing the world with the same generosity and clear-eyed attention Saunders does, even in the most absurd of circumstances.
From the #1 New York Times bestselling author of Lincoln in the Bardo, a darkly comic short story about the unintended consequences unleashed by our quest to tame the natural world—featuring gorgeous black-and-white illustrations by Chelsea Cardinal. Fox 8 has always been known as the daydreamer in his pack, the one his fellow foxes regard with a knowing snort and a roll of the eyes. That is, until he develops a unique skill: He teaches himself to speak “Yuman” by hiding in the bushes outside a house and listening to children’s bedtime stories. The power of language fuels his abundant curiosity about people—even after “danjer” arrives in the form of a new shopping mall that cuts off his food supply, sending Fox 8 on a harrowing quest to help save his pack. Told with his distinctive blend of humor and pathos, Fox 8 showcases the extraordinary imaginative talents of George Saunders, whom The New York Times called “the writer for our time.”
Since its publication in 1996, George Saunders’s debut collection has grown in esteem from a cherished cult classic to a masterpiece of the form, inspiring an entire generation of writers along the way. In six stories and a novella, Saunders hatches an unforgettable cast of characters, each struggling to survive in an increasingly haywire world. With a new introduction by Joshua Ferris and a new author’s note by Saunders himself, this edition is essential reading for those seeking to discover or revisit a virtuosic, disturbingly prescient voice. Praise for George Saunders and CivilWarLand in Bad Decline “It’s no exaggeration to say that short story master George Saunders helped change the trajectory of American fiction.”—The Wall Street Journal “Saunders’s satiric vision of America is dark and demented; it’s also ferocious and very funny.”—Michiko Kakutani, The New York Times “George Saunders is a writer of arresting brilliance and originality, with a sure sense of his material and apparently inexhaustible resources of voice. [CivilWarLand in Bad Decline] is scary, hilarious, and unforgettable.”—Tobias Wolff “Saunders makes the all-but-impossible look effortless.”—Jonathan Franzen “Not since Twain has America produced a satirist this funny.”—Zadie Smith “An astoundingly tuned voice—graceful, dark, authentic, and funny—telling just the kinds of stories we need to get us through these times.”—Thomas Pynchon
The only full-length study of the Brunei Sultanate from the earliest times to the present. First published in 1994 and a sell-out success, RoutledgeCurzon is pleased to present this new edition, updated to the present. Saunders skilfully elucidates historiographical controversies over important events, persons and developments in Brunei's past which are still important issues in defining Brunei's identity and its political and social systems today. These controversies, over the antecedents of the Sultanate, the date of the conversion to Islam, the reigns of the early sultans, early contacts with Europeans and others, retain their relevance. Newly presented are interpretations of events since 1945 during the transition from protected state to full independence, and thence to the present Malay Islamic Monarchy.
Saunders is an astoundingly tuned voice - graceful, dark, authentic and funny - telling just the kind of stories we need to get us through these times' Thomas Pynchon In PASTORALIA elements of contemporary life are twisted, merged and amplified into a slightly skewed version of modern America. A couple live and work in a caveman theme-park, where speaking is an instantly punishable offence. A born loser attends a self-help seminar where he is encouraged to rid himself of all the people who are 'crapping in your oatmeal'. And a male exotic dancer and his family are terrorised by their decomposing aunt who visits them with a solemn message from beyond the grave. With an uncanny combination of deadpan naturalism and uproarious humour, George Saunders creates a world that is both indelibly original and yet hauntingly familiar ...
#1 NEW YORK TIMES BESTSELLER • WINNER OF THE MAN BOOKER PRIZE The “devastatingly moving” (People) first novel from the author of Tenth of December: a moving and original father-son story featuring none other than Abraham Lincoln, as well as an unforgettable cast of supporting characters, living and dead, historical and invented One of The New York Times’s 100 Best Books of the 21st Century • One of The Atlantic’s Great American Novels of the Past 100 Years • One of Paste’s Best Novels of the Decade Named One of the Ten Best Books of the Year by The Washington Post, USA Today, and Maureen Corrigan, NPR • One of Time’s Ten Best Novels of the Year • A New York Times Notable Book • One of O: The Oprah Magazine’s Best Books of the Year February 1862. The Civil War is less than one year old. The fighting has begun in earnest, and the nation has begun to realize it is in for a long, bloody struggle. Meanwhile, President Lincoln’s beloved eleven-year-old son, Willie, lies upstairs in the White House, gravely ill. In a matter of days, despite predictions of a recovery, Willie dies and is laid to rest in a Georgetown cemetery. “My poor boy, he was too good for this earth,” the president says at the time. “God has called him home.” Newspapers report that a grief-stricken Lincoln returns, alone, to the crypt several times to hold his boy’s body. From that seed of historical truth, George Saunders spins an unforgettable story of familial love and loss that breaks free of its realistic, historical framework into a supernatural realm both hilarious and terrifying. Willie Lincoln finds himself in a strange purgatory where ghosts mingle, gripe, commiserate, quarrel, and enact bizarre acts of penance. Within this transitional state—called, in the Tibetan tradition, the bardo—a monumental struggle erupts over young Willie’s soul. Lincoln in the Bardo is an astonishing feat of imagination and a bold step forward from one of the most important and influential writers of his generation. Formally daring, generous in spirit, deeply concerned with matters of the heart, it is a testament to fiction’s ability to speak honestly and powerfully to the things that really matter to us. Saunders has invented a thrilling new form that deploys a kaleidoscopic, theatrical panorama of voices to ask a timeless, profound question: How do we live and love when we know that everything we love must end? “A luminous feat of generosity and humanism.”—Colson Whitehead, The New York Times Book Review “A masterpiece.”—Zadie Smith
J. Saunders Redding (1906-1988) was often and justifiably called "the dean of African American scholars." As professor and man of letters, he wrote about African American literature and culture in vivid and scholarly prose. And of all the writers of his generation, he best represented, and came closest to explaining, the hopes and conflicts of American democracy in a multiracial society. Yet his perceptions and writings were never limited to race, nationality, academia, or one literary genre. In this first published anthology drawn from Redding's books, essays, and speeches, Faith Berry has compiled representative selections from every period and genre in which Redding wrote: autobiography, fiction, biography, history, journalism, travelogue, and literary criticism. The collection offers a wide range of his thought and criticism from numerous publications, as well as a comprehensive bibliography of his works. Redding is essential reading for all those who argue for or against the intellectual credo he espoused: that African American writing and culture be studied in the context of American life and culture, not in insolation. This useful and balanced edition of Redding's writing should serve to introduce him to a new audience certain to find his texts worthy of attention and discussion. Readers concerned with literary and social history, higher education, race relations, American and ethnic studies, foreign affairs, cultural exchange -- or indeed the humanities in general -- will find this work an important resource. Contemporary African American scholars will value the book as a lasting reference. And anyone unfamiliar with Redding's work will discover and appreciate the breadth of his contributions to scholarship and literature.
NEW YORK TIMES BESTSELLER • This inspiring meditation on kindness from the author of Lincoln in the Bardo is based on his popular commencement address. Three months after George Saunders gave a graduation address at Syracuse University, a transcript of that speech was posted on the website of The New York Times, where its simple, uplifting message struck a deep chord. Within days, it had been shared more than one million times. Why? Because Saunders’s words tap into a desire in all of us to lead kinder, more fulfilling lives. Powerful, funny, and wise, Congratulations, by the way is an inspiring message from one of today’s most influential and original writers. Praise for Congratulations, by the way “As slender as a psalm, and as heavy.”—The New York Times “The graduating college senior in your life probably just wants money. But if you want to impart some heartfelt, plainspoken wisdom in addition to a check, you can't do much better than [Congratulations, by the way].”—Entertainment Weekly “The loving selflessness that [George Saunders] advises and the interconnectedness that he recognizes couldn’t be purer or simpler—or more challenging.”—Kirkus Reviews “Warm and tender.”—Publishers Weekly
During the Cold War, freedom of expression was vaunted as liberal democracy's most cherished possession—but such freedom was put in service of a hidden agenda. In The Cultural Cold War, Frances Stonor Saunders reveals the extraordinary efforts of a secret campaign in which some of the most vocal exponents of intellectual freedom in the West were working for or subsidized by the CIA—whether they knew it or not. Called "the most comprehensive account yet of the [CIA's] activities between 1947 and 1967" by the New York Times, the book presents shocking evidence of the CIA's undercover program of cultural interventions in Western Europe and at home, drawing together declassified documents and exclusive interviews to expose the CIA's astonishing campaign to deploy the likes of Hannah Arendt, Isaiah Berlin, Leonard Bernstein, Robert Lowell, George Orwell, and Jackson Pollock as weapons in the Cold War. Translated into ten languages, this classic work—now with a new preface by the author—is "a real contribution to popular understanding of the postwar period" (The Wall Street Journal), and its story of covert cultural efforts to win hearts and minds continues to be relevant today.
First Published in 1971 The History of the Mongol Conquests presents a general history of the Mongols of the thirteenth century. By using primary and secondary sources, J. J. Saunders fills up a major gap in the English historical literature on the subject. It goes without saying that the Mongol conquests of the thirteenth century turned the world upside down. The book opens with a chapter on Eurasian nomadism and an account of the Turkish conquests, seven centuries before those of the Mongols. The author deals fully with Chingis Khan and his achievements both as a soldier and as an administrator and goes on to describe the Mongol drive into the Europe and the Christian response to it. Mongol rule in China and Persia and their dominance in Russia are also covered. Rich in archival sources, this book is a must read for scholars and researchers of Asian and Central Asian history.
During the Cold War, writers and artists were faced with a huge challenge. In the Soviet world, they were expected to turn out works that glorified militancy, struggle and relentless optimism. In the West, freedom of expression was vaunted as liberal democracy's most cherished possession. But such freedom could carry a cost.
Scholars of British America generally conclude that the early eighteenth-century Anglo-American empire was commercial in economics, liberal in politics, and parochial in policy, somnambulant in an era of “salutary neglect,” but Stephen Saunders Webb here demonstrates that the American provinces, under the spur of war, became capitalist, coercive, and aggressive, owing to the vigorous leadership of career army officers, trained and nominated to American government by the captain general of the allied armies, the first duke of Marlborough, and that his influence, and that of his legates, prevailed through the entire century in America. Webb’s work follows the duke, whom an eloquent enemy described as “the greatest statesman and the greatest general that this country or any other country has produced,” his staff and soldiers, through the ten campaigns, which, by defanging France, made the union with Scotland possible and made “Great Britain” preeminent in the Atlantic world. Then Webb demonstrates that the duke’s legates transformed American colonies into provinces of empire. Marlborough’s America, fifty years in the making, is the fourth volume of The Governors-General.
San Antonio Man Tells Tall Tale is a memoir of a south Texas boy coming of age in the second half of the twentieth century. Each tale more thrilling than the last, the book chronicles a lifetime of hunting, fishing, and traveling throughout Texas, the Gulf Coast, the Rocky Mountains, and South America. These powerful and often humorous stories of chasing white tail deer, avoiding snakes, fishing for blue marlin, and even courting his wife are based on the author’s experiences in the great outdoors with close friends and family. Colorful illustrations by San Antonio artists Clay McGaughy and Pat Safir bring the stories to life. In the end, the reader will find that these are not tall tales at all, but the real life experiences of a lucky kid growing up in South Texas. Filled with humorous twists and turns, this book makes for a fun read for anyone.
A Second Collection of the Dark Humor Satire of R. L. Saunders Life in our dystopian near-futures has never been funnier. Sauders gets inspiration from our daily news, and these stories are therapy for us as well. Skewering what is accepted as conventional wisdom, Saunders explores concepts which are more easily delivered with entertainment than op-eds or tweet-storms. Always taking the ""what if"" of current controversies to their slippery-slope results, Saunders reminds us constantly to not take the world around us seriously. This anthology contains: Smart Home Revenge by R. L. Saunders and S. H. Marpel For the Love of 'Cagga by C. C. Brower & R. L. Saunders Synco (TM) by J. R. Kruze & R. L. Saunders The Lonely Witness by R. L. Saunders Beltway Gremlin by R. L. Saunders Get Your Copy Now.
The first full biography of the southern U.S. Supreme Court justice who championed both the U.S. Constitution and states’ rights The life of John Archibald Campbell reflects nearly every major development of 19th-century American history. He participated either directly or indirectly in events ranging from the Indian removal process of the 1830s, to sectionalism and the Civil War, to Reconstruction and redemption. Although not a defender of slavery, he feared that abrupt abolition would produce severe economic and social dislocation. He urged southerners to reform their labor system and to prepare for the eventual abolition of slavery. In the early 1850s he proposed a series of reforms to strengthen slave families and to educate the slaves to prepare them for assimilation into society as productive citizens. These views distinguished him from many southerners who steadfastly maintained the sanctity of the peculiar institution. Born and schooled in Georgia, Campbell moved to Montgomery, Alabama, in the early 1830s, where he joined a successful law practice. He served in the Alabama legislature for a brief period and then moved with his family to Mobile to establish a law practice. In 1853 Campbell was appointed an associate justice of the U.S. Supreme Court. His concurring opinion in the Dred Scott case in 1857 derived not from the standpoint of protecting slavery but from an attempt to return political power to the states. As the sectional crisis gathered heat, Campbell counseled moderation. He became widely detested in the North because of his defense of states’ rights, and he was distrusted in the South because of his moderate views on slavery and secession. In May 1861 Campbell resigned from the Court and later became the Confederacy's assistant secretary of war. After the war, Campbell moved his law practice to New Orleans. Upon his death in 1889, memorial speakers in Washington, D.C., and New Orleans recognized him as one of the nation's most gifted lawyers and praised his vast learning and mastery of both the common law and the civil law. In this first full biography of Campbell, Robert Saunders, Jr., reveals the prevalence of anti-secession views prior to the Civil War and covers both the judicial aspects and the political history of this crucial period in southern history.
NEW YORK TIMES BESTSELLER • NATIONAL BOOK AWARD FINALIST • NAMED ONE OF TIME’S TEN BEST FICTION BOOKS OF THE DECADE • NAMED ONE OF THE BEST BOOKS OF THE DECADE BY ENTERTAINMENT WEEKLY AND BUZZFEED • NAMED ONE OF THE TEN BEST BOOKS OF THE YEAR BY THE NEW YORK TIMES BOOK REVIEW One of the New York Times’s 100 Best Books of the 21st Century A BEST BOOK OF THE YEAR: People, The New York Times Magazine, NPR, Entertainment Weekly, New York, The Telegraph, BuzzFeed, Kirkus Reviews, BookPage, Shelf Awareness Includes an extended conversation with David Sedaris One of the most important and blazingly original writers of his generation, George Saunders is an undisputed master of the short story, and Tenth of December is his most honest, accessible, and moving collection yet. In the taut opener, “Victory Lap,” a boy witnesses the attempted abduction of the girl next door and is faced with a harrowing choice: Does he ignore what he sees, or override years of smothering advice from his parents and act? In “Home,” a combat-damaged soldier moves back in with his mother and struggles to reconcile the world he left with the one to which he has returned. And in the title story, a stunning meditation on imagination, memory, and loss, a middle-aged cancer patient walks into the woods to commit suicide, only to encounter a troubled young boy who, over the course of a fateful morning, gives the dying man a final chance to recall who he really is. A hapless, deluded owner of an antiques store; two mothers struggling to do the right thing; a teenage girl whose idealism is challenged by a brutal brush with reality; a man tormented by a series of pharmaceutical experiments that force him to lust, to love, to kill—the unforgettable characters that populate the pages of Tenth of December are vividly and lovingly infused with Saunders’s signature blend of exuberant prose, deep humanity, and stylistic innovation. Writing brilliantly and profoundly about class, sex, love, loss, work, despair, and war, Saunders cuts to the core of the contemporary experience. These stories take on the big questions and explore the fault lines of our own morality, delving into the questions of what makes us good and what makes us human. Unsettling, insightful, and hilarious, the stories in Tenth of December—through their manic energy, their focus on what is redeemable in human beings, and their generosity of spirit—not only entertain and delight; they fulfill Chekhov’s dictum that art should “prepare us for tenderness.” GEORGE SAUNDERS WAS NAMED ONE OF THE 100 MOST INFLUENTIAL PEOPLE IN THE WORLD BY TIME MAGAZINE
Twenty-three centuries after its compilation, 'The Politics' still has much to contribute to this central question of political science. Aristotle's thorough and carefully argued analysis is based on a study of over 150 city constitutions, covering a huge range of political issues in order to establish which types of constitution are best - both ideally and in particular circumstances - and how they may be maintained. Aristotle's opinions form an essential background to the thinking of philosophers such as Thomas Aquinas, Machiavelli and Jean Bodin and both his premises and arguments raise questions that are as relevant to modern society as they were to the ancient world.
Alexander the Great is a towering figure in world history, but despite our long-held fascination with him, his burial site is unknown. Alexander's Tomb is the epic tale of the ongoing quest to unlock one of the world's great mysteries.
This is an introduction to the history of the Muslim East from the rise of Islam to the Mongol conquests. It explains and indicates the main trends of Islamic historical evolution during the Middle Ages, and will help the non-Orientalist to understand something of the relationship between Islam and Christendom in those centuries.
This classic study of American Black poetry, first published in 1939 and long out of print, is the work of perhaps the pre-eminent figure in Black Studies of the past two generations. A major contribution to the history of Black thought in America, it ranges widely, beginning in the late eighteenth century with Jupiter Hammon, the first American Black writer, and ending in the 1930s with Countee Cullen and Langston Hughes.
This report assesses the effectiveness of correctional education programs for both incarcerated adults and juveniles and the cost-effectiveness of adult correctional education. It also provides results of a survey of U.S. state correctional education directors that give an up-to-date picture of what correctional education looks like today. Finally, the authors offer recommendations for improving the field of correctional education moving forward.
Many of the deep-rooted human conflicts that seize our attention today are not ready for formal mediation and negotiation. People do not negotiate about identity, fear, historic grievance, and injustice. Sustained dialogue provides a space where citizens outside government can change their conflictual relationships. Governments can negotiate binding agreements and enforce and implement them, but only citizens can change human relationships. Governments have long had their tools of diplomacy - mediation, negotiation, force, and allocation of resources. Harold H. Saunders' A Public Peace Process provides citizens outside government with their own instrument for transforming conflict. Saunders outlines a systematic approach for citizens to use in reducing racial, ethnic, and other deep-rooted tensions in their countries, communities, and organizations.
Like a newly discovered treasure map offering a path to buried riches, Foxes in the Henhouse is a hard-hitting political blueprint for how the Democrats can win again in the South and rural America. The authors document the Republicans' rise in the South and Midwest, expose the hypocrisy that marked their ascent, and offer a take-no-prisoners plan to kick them out. The authors know of what they speak. "Rural strategists" Steve Jarding and Dave "Mudcat" Saunders are famous for securing Democratic victories in places they shouldn't have -- most notably in Mark Warner's successful run for governor of Virginia, a campaign that wasn't afraid to use bluegrass concerts and NASCAR to get the message out. When George W. Bush swept the South clean in 2004, it was the final insult to Jarding and Saunders, two self-proclaimed "bubbas" on a mission to convince their fellow southerners and rural Americans that the GOP's claim of representing "values," patriotism, the sportsmen, and fiscal conservatism is a disastrous farce. In addition to exposing the lies behind the gradual Republican invasion of the hinterland that began in the 1960s, they offer some surprisingly simple strategies for Democrats to capture each of these issues. Among other things, Jarding and Saunders urge Democrats to • Quit turning their noses up at the culture of rural America and talk to people where they live • Learn how to count when going after votes • Show some passion and retaliate when Republicans assassinate their characters Packed with meticulous and shocking research findings; blunt, laugh-out-loud language; and merciless assaults on George W. Bush, Tom DeLay, Bill O'Reilly, and plenty of other right-wing charlatans, Foxes in the Henhouse is a must-read and will be one of the most talked-about books of the year and for election cycles to come.
In this, his first collection of essays, Saunders trains his eye on the real world rather than the fictional and reveals it to be brimming with wonderful, marvellous strangeness. As he faces a political and cultural reality saturated with lazy media, false promises and political doublespeak, Saunders invokes the wisdom of American literary heroes Twain, Vonnegut and Barthelme and inspires us to re-examine our assumptions about the world we live in, as we struggle to discover what is really there.
In presenting this treatment of homological algebra, it is a pleasure to acknowledge the help and encouragement which I have had from all sides. Homological algebra arose from many sources in algebra and topology. Decisive examples came from the study of group extensions and their factor sets, a subject I learned in joint work with OTTO SCHIL LING. A further development of homological ideas, with a view to their topological applications, came in my long collaboration with SAMUEL ElLENBERG; to both collaborators, especial thanks. For many years the Air Force Office of Scientific Research supported my research projects on various subjects now summarized here; it is a pleasure to acknowledge their lively understanding of basic science. Both REINHOLD BAER and JOSEF SCHMID read and commented on my entire manuscript; their advice has led to many improvements. ANDERS KOCK and JACQUES RIGUET have read the entire galley proof and caught many slips and obscurities. Among the others whose sug gestions have served me well, I note FRANK ADAMS, LOUIS AUSLANDER, WILFRED COCKCROFT, ALBRECHT DOLD, GEOFFREY HORROCKS, FRIED RICH KASCH, JOHANN LEICHT, ARUNAS LIULEVICIUS, JOHN MOORE, DIE TER PUPPE, JOSEPH YAO, and a number of my current students at the University of Chicago - not to m~ntion the auditors of my lectures at Chicago, Heidelberg, Bonn, Frankfurt, and Aarhus. My wife, DOROTHY, has cheerfully typed more versions of more chapters than she would like to count. Messrs.
Baby Birds describes and illustrates the development of young robins from hatching to leaving the nest. The other three titles in the series present information on different types of birds. Readers examine various eggs, nests, and family groupings. The close picture-text matches in this series support early readers. This series explores and supports the standard "The Living Environment: Diversity of Life," as required by Benchmarks for Science Literacy: Project 2061.
The United States has the highest per capita spending on health care of any industrialized nation but continually lags behind other nations in health care outcomes including life expectancy and infant mortality. National health expenditures are projected to exceed $2.5 trillion in 2009. Given healthcare's direct impact on the economy, there is a critical need to control health care spending. According to The Health Imperative: Lowering Costs and Improving Outcomes, the costs of health care have strained the federal budget, and negatively affected state governments, the private sector and individuals. Healthcare expenditures have restricted the ability of state and local governments to fund other priorities and have contributed to slowing growth in wages and jobs in the private sector. Moreover, the number of uninsured has risen from 45.7 million in 2007 to 46.3 million in 2008. The Health Imperative: Lowering Costs and Improving Outcomes identifies a number of factors driving expenditure growth including scientific uncertainty, perverse economic and practice incentives, system fragmentation, lack of patient involvement, and under-investment in population health. Experts discussed key levers for catalyzing transformation of the delivery system. A few included streamlined health insurance regulation, administrative simplification and clarification and quality and consistency in treatment. The book is an excellent guide for policymakers at all levels of government, as well as private sector healthcare workers.
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