Curing the Crisis: Options for America's Health Care.

• Author: Lane, Julia

The importance of health care reform is obvious to anyone living in the United States today: it was a major issue in the presidential election, and continues to have almost daily coverage in the nation's major newspapers. Furthermore, almost every American has an opinion on What Should Be Done. It is difficult, however, for people not intimately involved in the field to keep track of all the different reform proposals--or even to identify whether the proposals such as pay or play, national health insurance and managed competition are the same beast under different names. Reagan's book plays a useful role in providing background information in a non-technical survey of the key issues. This is no mean achievement in view of the complexity of the subject, so I may be cavilling when I mention several distressing flaws. The first is that although the general outline of the book is logical, the organization within each chapter is poor, and it is difficult to follow the author's train of thought. This confusion is compounded by the somewhat incongruous writing style (especially evident in Chapter One) used to convey different points of view and the occasional tendency to jumble many thoughts together. Furthermore, although the author does a yeoman's task describing the costs and benefits of the different reform proposals, he fails to provide any quantitative estimates. In other words, since the book is written by a political scientist rather than an economist, the general approach may be jarring to readers trained in economics. A further flaw which is not attributable to the author is the inevitable tendency of books to become outdated almost as soon as they come off the press--thus the failure to discuss any specifics of Clinton's health care options.

Part One of the book is entitled "A Snapshot of Health Care Delivery Today." Although the writing in the first chapter is leaden, it does provide a useful "straw man" summary of the views of different participants in the field, and contrasts nicely with Chapter Two's more factual description of the current "system." Chapter Two is unfortunately rather jumbled: the description of the system today precedes the historical description; the orienting questions; the subheadings and occasionally even the headings frequently do not reflect the content of the text; bald assertions are made without substantiating evidence or references and the language is often vague. For example, under the subheading "An...