Content area
Full Text
Understanding Health Policy: A Clinical Approach (4th Ed.) Thomas Bodenheimer and Kevin Grumbach New York: Lange Medical Books/McGraw-Hill, 2005, 388 pp., $34.95 (softcover)
In 1929, Baylor University Hospital charged 1,500 Dallas school teachers 6 dollars per year for 21 days of prepaid hospital care (Bodenheimer & Grumbach). This marked the beginning of hospital-centered private insurance plans. In the early 1940s, the American Hospital Association renamed itself Blue Cross and provided prepaid hospital insurance plans to over 6 million people (Bodenheimer & Grumbach). Its counterpart, Blue Shield, was created in 1939 to defray physician care costs. Later, because of World War II and the labor shortages, employment unions negotiated employee health insurance plans as a "fringe benefit" (Bodenheimer Sf Grumbach, p. 7). As a result, the number of individuals insured with hospital plans grew from 12 million in 1940 to 142 million in 1988 (Bodenheimer & Grumbach). Private insurance plans decreased the rising costs of health care, but the generous reimbursements for hospitals and physicians were the primary impetus behind their development.
The historical background, recent changes, and the problems and possible solutions pertaining to health policy are discussed in the fourth edition of Bodenheimer and Grumbach's medical text, Understanding Health Policy: A Clinical Approach. As primary care physicians, Bodenheimer and Grumbach convey an original dimension to the text by accurately recounting the development of the American private insurance industry, its subsequent efforts with cost containment, and the century-old plight of a national health insurance plan....