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Jonas And Kovner's Health Care

Jonas and Kovner's Health Care Summary

Jonas and Kovner's Health Care Delivery in the United States is a highly acclaimed textbook on health care delivery and has been fully updated and revised. The 12th edition of this well regarded US health care textbook provides graduate and undergraduate students with a comprehensive survey of health care in the United States with topics ranging from the organization of care, the politics surrounding health care in the United States, to population health and vulnerable populations, health care costs and value, health care financing, and health information technology.

Chapters provide thorough coverage of the rapid changes that are reshaping our US healthcare system and the extent of our nation’s achievement of health care value and the Triple Aim: better health and better care at a lower cost. With an emphasis on population health and public health, this text includes a timely focus on how social and physical environments influence health outcomes.

Prominent scholars, practitioners, and educators within public health, population health management, health policy, healthcare management, medical care, and nursing present the most up-to-date evidence-based information on social and behavioral determinants of health and health equity, immigrant health, health care workforce challenges, preventive medicine, innovative approaches to control healthcare costs, initiatives to achieve high quality and value-based care, and much more.

Designed for graduate and advanced undergraduate students of healthcare management and administration, nursing, and public health, the text addresses all complex core issues surrounding our US health care system and health policy, such as the challenges to health care delivery, the organization and politics of care, and comparative health systems. Organized in a readable and accessible format, contributors provide an in-depth and objective appraisal of why and how we organize health care the way we do, the enormous impact of health-related behaviors on the structure, function, and cost of the health care delivery system, and other emerging and recurrent issues in health policy, health care management, and public health.

The 12th edition of Jonas and Kovner's Health Care Delivery in the United States features the contributions of such luminaries as former editor Anthony R. Kovner, Michael K. Gusmano, Carolyn M. Clancy, Marc N. Gourevitch, Joanne Spetz, James Morone, Karen DeSalvo, and Christy Harris Lemak, among others. Chapters include audio chapter summaries with a discussion of newsworthy topics, learning objectives, discussion questions, case exercises, and new charts and tables with concrete health care data.

Included for instructors is an Instructor’s Manual, PowerPoint slides, Syllabus, Test Bank, Image Bank, Supplemental e-chapter on A Visual Overview of Health Care Delivery, access to an annual ACA update and health policy changes, extra cases and syllabus specifically for nurses, and a transition guide bridging the 11th and 12th editions.

Key Features:

  • Three completely revised chapters on the politics of health care, vulnerable populations, and health information technology
  • Expanded coverage on population health and population health management, health equity, influences of social determinants on health behavior and outcomes, health education planning, health workforce challenges, national and regional quality improvement initiatives and more
  • Revised e-Chapter providing A Visual Overview of Health Care Delivery and Image Bank for the 12th Edition
  • Access to Springer Publishing Company’s annual ACA update
  • Audio podcasts provide summaries for each chapter with real-world context of topics featured in the news
  • New appendix with overview of U.S. Government Public Health Agencies
  • Access to fully searchable ebook, including extra e-chapters and student ancillaries on Springer Publishing Connect
  • Full Instructor Packet including Instructor’s Manual, Test Bank, PowerPoint slides, Image Bank, and Case Exercises for Nursing Instructors

About the Author

James R. Knickman, Ph.D. is the Robert Derzon Chair in Public and Health Affairs at New York University with joint appointments at the NYU Wagner School of Public Service and at NYU Langone Medical School's Department of Population Health. He has spent four decades splitting his time between academe and the philanthropic sector.

His work focuses on health policy and he has played many roles both as a researcher and a leader in philanthropy to advance the use of public policy to improve the American health care system. He was a Vice President at the Robert Wood Johnson Foundation and President of the New York State Health Foundation. He has a Ph.D. in Public Policy Analysis from the University of Pennsylvania and did his undergraduate work at Fordham University. He serves on the Board of Directors at three non-profit organizations, including chairing the National Council on Aging.

Jonas and Kovner's Health Care Introduction

Excerpt. © Reprinted by permission. All rights reserved.

The Challenge of Health Care Delivery and Health Policy
Brian Elbel and James R. Knickman


  • Understand the importance of health and health care to American life
  • Describe defining characteristics of U.S. health care delivery
  • Discuss major issues and concerns
  • Identify key interest groups (stakeholders)
  • Explain the importance of engaging a new generation of health leaders


  •  access to health care
  • consumers
  • customer friendly
  • fee-for-service system
  • health care delivery
  • health maintenance
  • health system
  • Patient Protection and Affordable Care Act
  • population health
  • stakeholder
  • value
  • workforce


  •  Why health is so important to Americans
  • Defining characteristics of the U.S. health care delivery system
  • Factors that shape the structure of the delivery system
  • Seven key challenges facing the health system
  • Stakeholders who shape and are affected by how the health system is organized and how it functions
  • The organization of the book


Our goal in editing this book is to provide a vibrant introduction to the U.S. health care system in a way that helps new students understand the wonders of health and health care. The book lays out the complexities of organizing a large sector of our economy to keep Americans healthy and to help people get better when they become ill. In addition, the book provides a framework to help professors engage students, with room for each professor to bring his or her perspective to the materials covered.

To introduce students to the many parts of the health system in the United States, we have engaged some of the leading thinkers and “doers” in the health sector to explain the parts of the system in which they are expert. Each author brings a different perspective, and it is not our aim to present one voice on this topic. Rather, we have asked each author to lay out the facts about a given topic and to offer ideas about what he or she thinks must happen to improve a specific aspect of the health system.

In many ways, the text lays out a serious “to do” list facing our health system and offers individuals beginning a health-related career a guide to the types of challenges that could engage them. The authors explain how the health system works, its challenge, and how individuals can contribute to the process of strengthening our system to ensure it works efficiently and effectively at the task of keeping all of us healthy.

In this first chapter, we explain the importance of the health system, provide an overview of how the system is organized, sketch out some of the challenges facing the overall system addressed in the book, and discuss the roles of five types of key stakeholders involved in the health enterprise. We also provide the logic behind the topics the book addresses and explain the book’s organization.


Our nation is built on the idea that society should ensure an opportunity for “life, liberty, and the pursuit of happiness.” These words, of course, are from the second sentence of our Declaration of Independence. The aspiration of ensuring “life” is the core goal of the health system. It is obvious that nothing is possible for an individual without life, and most of us would agree that health is among the core needs to live a vibrant, viable life. Good health is essential to participate in the political and social system, to work to support ourselves and our families and to pursue happiness and a good life.

Our nation has invested a tremendous amount to learn how to keep people healthy and how to restore health when disease, injury, or illness occurs. In the 19th century, researchers and public health experts from the United States and other countries began to understand the role of germs in communicating disease and the importance of basic public health practices, such as ensuring clean water and safe sanitation to maintain health. In the 20th century, the science and art of medicine exploded, creating amazing know-how to treat people who have diseases, injuries, and illnesses.

In response to the emerging know-how for delivering medical care, a large and complex health enterprise developed throughout the 20th century and continues to evolve. The pipeline of new ideas for better treating illnesses is quite full and promises to lead to ever-expanding methods to restore health when Americans have life-threatening medical problems. We are now faced with “personalized medicine” or the promise or hope that big data can solve many problems related to health or health systems.

We use the word enterprise deliberately because the health system is a blend of an altruistic-oriented set of providers and activities mixed with a huge industry that accounts for a sizable portion of all economic activity in our society. The value we put on health has led us to devote just under 20% of our economic resources to medical care and health promotion (see Chapter 10, Figure 10.1). Fully 11% of all jobs in America are in the health sector (Altarum, 2018).

Each of us spends a sizable share of our income on the health care we need. We spend this money through taxes, which support a good share of the health enterprise; through foregone wages used by our employers to pay for health insurance; and by sizable out-of-pocket health care expenses for which each of us is responsible.

Thus, the pursuit of life, listed as a core principle in the Declaration of Independence, not only has resulted in a set of social and political norms about the importance of good health to everyone in America but also has spurred a huge industry that affects and is affected by society’s economic activity and economic decisions. To understand the health system, we need to understand not only the art and practice of medicine and public health but also the economic, organizational, and management issues that must be addressed to keep the health system effective, efficient, and affordable in our overall economic life.

How we go about organizing and managing the health system and changing it over time can hurt or help both our health status and our economic status.


It is ironic that most health professionals think of themselves as working within the health system when in truth one of the first defining features of what we call a system is that health-related activities are not ordered or organized as a single enterprise. Rather, efforts to improve health and health care involve many types of actors and organizations working independently and with little coordination to make contributions to improving health status. In particular, our current approach to delivering medical care has evolved and keeps evolving in a haphazard way shaped more by economic incentives and opportunities than by a central or logical design.

Equally importantly, this is not just about medical care, but social services and other systems in place that could have an even larger impact on health.

In recent years, we also have begun to recognize the clear difference between health maintenance and restoring health to a person who has a medical problem. The medical care system clearly takes charge of restoring health when people are ill.

Often the medical care system takes charge of caring for people even if restoring health is impossible; the goal may be to limit the spread of a medical problem, to alleviate the symptoms of a medical problem, or to help a person cope with the pain and suffering and loss of function when major medical problems emerge. Doctors, nurses, technicians of various types, hospitals, nursing homes, rehabilitation centers, pharmaceutical companies, and medical device companies are among the actors who engage in efforts to care for people when they have medical problems.

The goal of maintaining health also involves many actors and activities. To some extent, medical providers help with this huge task by providing screening and prevention services that can keep people from becoming ill and help to identify illnesses very early when they might be easier to treat. However, good health among a population also requires a vibrant public health and social service system that works to help people avoid illness.

Public health activities include preventing epidemics; making sure food, water, and sanitation are safe; monitoring environmental toxins; and developing community-based, public awareness, and education initiatives to help people eat healthy foods, exercise, and not engage in unhealthy behaviors such as smoking, drinking alcohol in excess, and using recreational drugs or abusing prescription drugs.

Adequate family incomes, high-quality educational opportunities, and being socially connected are all key factors that predict the health of a given person.

Increasingly, we also recognize that the health of populations is determined by social and economic factors. Adequate family incomes, high-quality educational opportunities, and being socially connected are all key factors that predict the health of a given person. Social issues such as discrimination, abuse, and social respect all are important determinants of health.

To ensure attention to these issues and others like them requires involvement from many sectors of our society as well as political leadership to guide collective action to ensure our society encourages pro-health norms and practices. Some people term this a “health in all” approach to social policy. The relatively new concept of population health has also worked its way into the health system, with such systems increasingly taking into account the lives of patients outside the walls of their buildings.

We have organized this book so that it addresses both types of health issue challenges: (a) keeping the population healthy and (b) providing effective medical care when needed. Other key defining characteristics of the U.S. health care system guide the organization of this book:

  The importance of organizations in delivering care. These include hospitals, nursing homes, community health centers, physician practices, social services agencies, and public health departments.

  • The role of professionals in running our system. These include physicians, nurses, managers, policy advocates, policy makers, researchers, technicians, and those directing technology and pharmaceutical businesses.
  • The emergence of new medical technology, smartphones, big data, and new pharmaceuticals. New techniques in imaging, smartphone-based apps, big data, machine learning, pharmaceuticals, surgical procedures, DNA coding, and stem-cell technology are remarkable but often expensive ways of improving health care.
  • Tension between “the free market” and “governmental control.” This tension shapes America’s culture but is sharply present, among the points of debate, in the health care sector. Relative to citizens of other countries, Americans have more diversity of opinion about whether health care, or certain health care services, are “goods” or “rights.” How one feels about this issue often determines whether a person thinks the delivery of health care should be done by nonprofit or for-profit organizations and whether health care should be financed by taxes or private payments.
  • A dysfunctional payment system. The traditional way we have paid health care providers rewards them for providing more and more billable services rather than rewarding them for being efficient and delivering effective care. This fee-for-service system has begun to change with more frequent use of payment approaches that reward valued services. But, we still have a long way to go to make it economically logical for providers to be efficient, to be customer or patient friendly, and to focus on the delivery of high-value services. Also, the payment approach is not transparent for individuals who use health care. For example, patients frequently have no idea what a service costs until after it is delivered. This is rarely true for other goods and services in the U.S. economy.

These defining characteristics make health care delivery a challenging part of U.S. politics and the economy. Addressing the challenges of delivering health care is worth the best effort and thinking of our readers, who are tomorrow’s health care leaders.

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Jonas And Kovner's Health Care

Jonas And Kovner's Health Care PDF

Product details:

Edition12th Edition
Posted onDecember 17, 2018
Page Count480 pages
AuthorJames R. Knickman

Jonas and Kovner's Health Care PDF Free Download - HUB PDF

Jonas and Kovner's Health Care Delivery in the United States is a highly acclaimed textbook on health care delivery and has been fully updated and revised. The 12th edition of this well regarded US health care textbook provides graduate and undergraduate students with a comprehensive survey of health care in the United States with topics ranging from the organization of care, the politics surrounding health care in the United States, to population health and vulnerable populations, health care costs and value, health care financing, and health information technology.


Author: James R. Knickman

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