The Rise and Fall of the HMO Movement: An American Health Care Revolution » (1)

Jan Gregoire Coombs is a medical historian living near Madison, Wisconsin. Her books on health care include You Can Help: Living with the Disabled.

Coombs, a medical historian, explains why HMOs have failed to improve services or control health care costs, using a real-life case study to examine the advantages and disadvantages of publicly and privately financed medical care. She discusses the implications of benefits coverage and pharmaceutical costs, and looks at issues such as ethics, clinical practice guidelines, managed care strategies, and patients' rights. The book will be valuable for those working in health policy research, health care management, and health law and politics. Annotation ©2004 Book News, Inc., Portland, OR

Publishers Weekly

Alternating a broad historical overview of HMOs with a close analysis of one institution, the Marshfield Clinic in northern Wisconsin, medical historian Coombs (You Can Help: Living with the Disabled) paints a sobering portrait of American health care. A rural multispecialty clinic long admired for its quality of care, Marshfield is, for Coombs, "emblematic" of the failure caused by federal legislation that began in the early 1970s and continued through the end of the century. Coombs marshals an array of statistics, anecdotes and extended narratives that point to the detrimental effects HMOs have had on both patients and the providers. With a gift for deciphering and articulating complex scenarios, Coombs provides readers with the necessary historical background to understand HMOs. For instance, her deft treatment of the history of health-care economics and the political motivations behind the 1973 Health Maintenance Organization Act allows the reader to better grasp how employer-based systems, in her assessment, have led to care that is inequitable, wasteful and financially woeful when the benefits are evaluated against the costs. Coombs also offers prescriptions. Health-care policy makers and administrators will appreciate Coombs's thoroughness, and while the lay reader may struggle with pages devoted to arcane health-care legislation, this book makes a critical contribution to medicine and its literature. (Mar.) Copyright 2005 Reed Business Information.