Full Description
Health care costs make up nearly a fifth of U.S. gross domestic product, but health care is a peculiar thing to buy and sell. Both a scarce resource and a basic need, it involves physical and emotional vulnerability and at the same time it operates as big business. Patients have little choice but to trust those who provide them care, but even those providers confront a great deal of medical uncertainty about the services they offer. Selling Our Souls looks at the contradictions inherent in one particular health care market--hospital care. Based on extensive interviews and observations across the three hospitals of one California city, the book explores the tensions embedded in the market for hospital care, how different hospitals manage these tensions, the historical trajectories driving disparities in contemporary hospital practice, and the perils and possibilities of various models of care. As Adam Reich shows, the book's three featured hospitals could not be more different in background or contemporary practice. PubliCare was founded in the late nineteenth century as an almshouse in order to address the needs of the destitute.
HolyCare was founded by an order of nuns in the mid-twentieth century, offering spiritual comfort to the paying patient. And GroupCare was founded in the late twentieth century to rationalize and economize care for middle-class patients and their employers. Reich explains how these legacies play out today in terms of the hospitals' different responses to similar market pressures, and the varieties of care that result. Selling Our Souls is an in-depth investigation into how hospital organizations and the people who work in them make sense of and respond to the modern health care market.
Contents
Introduction 1 PART ONE PubliCare Rebuffs the Market 19 Chapter 1 Health Care for All 26 Chapter 2 Privileged Servants 48 Chapter 3 Feels Like Home 59 PART TWO HolyCare Moralizes the Market 71 Chapter 4 Sacred Encounters 78 Chapter 5 Good Business 95 Chapter 6 The Martyred Heart 109 PART THREE GroupCare Tames the Market 123 Chapter 7 Flourishing 127 Chapter 8 Disciplined Doctors 147 Chapter 9 PARTnership 171 Conclusion 189 Acknowledgments 199 A Note on Methods 201 Notes 205 Bibliography 213 Index 221
