Hospital City, Health Care Nation: Race, Capital, and the Costs of American Health Care (Politics and Culture in Modern America)

__Hospital City, Health Care Nation__ recasts the story of the health care system by emphasizing the economic and social importance of hospitals in American communities. While hospitals have become vital economic anchors in cities across the country, the spending that supports them has constrained possibilities for comprehensive health care reform. __Hospital City, Health Care Nation__ recasts the story of the U.S. health care system by emphasizing its economic, social, and medical importance in American communities. Focusing on urban hospitals and academic medical centers, the book argues that the country’s high level of health care spending has allowed such institutions to become vital, if often problematic, economic anchors for communities. Yet that spending has also constrained possibilities for comprehensive health care reform over many decades, even after the passage of the Affordable Care Act in 2010. At the same time, the role of hospitals in urban renewal, in community health provision, and as employers of low-wage workers has contributed directly to racial health disparities. Guian A. McKee explores these issues through a detailed historical case study of Baltimore’s Johns Hopkins Hospital while also tracing their connections across governmental scales—local, state, and federal. He shows that health care spending and its consequences, rather than insurance coverage alone, are core issues in the decades-long struggle over the American health care system. In particular, __Hospital City, Health Care Nation__ points to the increased role of financial capital after the 1960s in shaping not only hospital growth but also the underlying character of these vital institutions. The book shows how hospitals’ quest for capital has interacted with structural racism and inequality to shape and constrain the U.S. health care system. Building on this reassessment of the hospital system, its politics, and its financing, __Hospital City, Health Care Nation__ offers ideas for the next steps in health care reform. CONTENTS Abbreviations Used in Text Introduction. Crisis in the Hospital City—and the Health Care Nation PART I. BUILDING THE HOSPITAL CITY 1. The Public Foundations of the Hospital City 2. Urban Renewal in the Hospital City 3. Medicare, Hospitals, and “the Gold at Fort Knox” 4. Johns Hopkins in the Hospital Metropolis PART II. LIVING WITH THE HOSPITAL CITY 5. The Hospital City and the National Health Insurance Struggle 6. Wages, Jobs, and Cost in the Hospital City 7. Hospital Cost Control in Maryland 8. To Stay or Go, and How to Pay for It PART III. COSTS OF THE HOSPITAL CITY 9. “The Dream Shall Never Die” . . . but It May Be Compromised 10. “A New Emphasis on Market Strategies” 11. Markets, Medicaid, and Mergers Conclusion. Reform in the Hospital City—and the Health Care Nation Abbreviations Used in Notes Notes Index Acknowledgments "This book recasts the story of the health care system by emphasizing the economic and social importance of hospitals in American communities. While hospitals have become vital economic anchors in cities across the country, the spending that supports them has constrained possibilities for comprehensive health care reform"-- Provided by publisher