The U.S. Health System: Origins and Functions,
7th Edition

Harry Holt, Camille K Barsukiewicz, Norma Raffel, Marshall W. Raffel

ISBN-13: 9780357621943
Copyright 2025 | Not Yet Published (2024-10-18)
256 pages | List Price: USD $187.95

Examine the delivery of health care in United States (U.S.) using the unique systems approach in THE U.S. HEALTH SYSTEM: ORIGINS AND FUNCTIONS, 7E. This edition establishes a meaningful historic context for modern health care that clearly shows how the U.S. system has developed and continues to change. You review major systems that determine health care costs, access and quality and learn about key stakeholders, such as patients and families, nurses, physicians, payer and policy-makers. You examine processes for reimbursement and policy change, while updates address issues such as health care reform, technology, the COVID-19 pandemic, the opioid crisis and challenges for rural patients. You also study social determinates and their influence on population health. Discussions focus on ethics, policy, reform, equity and inclusion and activity-based learning encourages research and first-hand interviews. MindTap digital resources are also available to strengthen your understanding.


1. Introduction.
2. Health Care Costs.
3. Paying for Health Care Services.
4. Health Status and Health Care Utilization.
5. Medical Education.
6. Professions in Health Care.
7. Ambulatory Care.
8. Hospitals.
9. Mental Health Services.
10. Long-Term Care.
11. Public Health - The Health of the Community.
12. Information Management Systems.
13. Current Issues in Health Care Delivery.

  • Harry Holt

    Harry D. Holt, Ph.D., is recognized for his research on identifying factors that influence the financial performance and profitability of hospitals and health systems. He has also focused on the role of integrated public health teams in delivering Medication Assisted Treatment (MAT) to urban and rural populations. Dr. Holt has studied the unique challenges faced by rural patients and the stigma that is a barrier for them to receive treatment. This work has identified opportunities for interprofessional teams to implement best practices in MAT services. The results of this work have influenced policy makers who make reimbursement decisions and health systems as they develop MAT services for their patients. As coordinator of the health care management track in the masters of public health program at West Chester University of Pennsylvania, Dr. Holt has mentored underrepresented students as they develop skills in public health. Upon graduation, many of these students have led interprofessional teams and served as administers for state and local providers. These providers deliver opioid use disorder treatment services and other critical public health services to underrepresented populations. Dr. Holt is a graduate of Indiana University of Pennsylvania with degrees in economics, political science and pre-law. He also graduated from Case Western Reserve University with juris doctorate (J.D.) and an M.B.A. with a focus in health systems management. Dr. Holt earned his Ph.D. in health policy and administration from Pennsylvania State University.

  • Camille K Barsukiewicz

    Camille K. Barsukiewicz, Ph.D., is a professor in the School of Urban Affairs and Public Policy at the University of Memphis in Tennessee.

  • Norma Raffel

  • Marshall W. Raffel

    Marshall W. Raffel, Ph.D., is a professor emeritus of health policy and administration at The Pennsylvania State University in University Park, Pennsylvania.

  • UPDATES AND THE LATEST CONTENT ASSESS THE IMPACT OF COVID-19 ON TODAY’S HEALTH SYSTEM. New material carefully examines and evaluates the immediate and long-term influences and effects of the COVID-19 pandemic on the U.S. health care system.

  • REVISED, INCLUSIVE PERSPECTIVE EXPLORES SOCIAL DETERMINATES OF HEALTH. The authors take a diverse, equitable and inclusive viewpoint as this edition carefully examines the social determinates of health and their influence in the U.S. health care system. Engaging discussions review how socioeconomic status, education, employment and other factors impact an individual’s access to health care.

  • NEW CONTENT EXAMINES THE LATEST DEVELOPMENTS IN HEALTH CARE REFORM. Current material and updates explore new developments in health care reform initiated by the U.S. Congress and the U.S. Supreme Court. Students learn about actions taking place to improve quality of care and make health care more affordable for all.

  • UPDATES EXAMINE ISSUES RELATED TO COVID-19 VACCINE MANDATES AND EMPLOYMENT IN HEALTH CARE. Thought-provoking content assesses health care issues related to COVID-19 vaccine mandates. New content also reviews issues and challenges in health care staffing related to the COVID-19 pandemic.

  • REVISIONS EXAMINE THE USE OF TECHNOLOGY AND ARTIFICAL INTELLIGENCE (AI) IN TODAY’S HEALTH CARE. The latest updates review how the health care technology and advancements in AI are providing opportunities for patients to manage their own health and wellbeing.

  • NEW CONTENT REVIEWS THE IMPACT OF THE PANDEMIC, THE OPIOD CRISIS AND OTHER INFLUENCES ON MENTAL HEALTH. New discussions review how the COVID-19 pandemic, the opioid crisis and even reimbursement issues are currently influencing patient access to mental and behavioral health care in the U.S.

  • NEW ACTIVITY-BASED LEARNING QUESTIONS GUIDE STUDENTS IN ADDITIONAL STUDY. These new activity-based learning questions provide specific prompts and guides for students who wish to further explore issues of individual interest. Students are directed to reliable, meaningful sources for more information on topics of personal and professional interest.

  • UPDATED INTERNET LINKS DIRECT STUDENTS TO QUALITY RESOURCES FOR ADDITIONAL STUDY. The authors have carefully updated links to Internet sources throughout this edition, making it simple for students to pursue additional study and independently explore topics covered in the chapters.

  • BLENDED CONTENT EMPHASIZES BOTH HISTORICAL BACKGROUND AND CURRENT DEVELOPMENTS. The authors provide balanced coverage for a historic foundational understanding of health care in the U.S. with updates that highlight current viewpoints and the most recent developments in the delivery of the country’s health care.

  • IN-DEPTH COVERAGE OF SOCIAL DETERMINATES EMPHASIZES THEIR IMPACT AND IMPORTANCE IN HEALTH CARE TODAY. Insightful content explores how social determinates of health have profound influence on population measures of health. Students learn how to monitor health status and examine reasons for health disparities between specific populations.

  • MEANINGFUL CONTENT REVIEWS THE POSITIVE IMPACTS OF EQUITY AND INCLUSION ON HEALTH CARE. Current discussions throughout this edition emphasize diversity, equity and inclusion as well as how these factors can improve access to health care, patient satisfaction, quality of health care services and affordability in the U.S. health care system.

  • INSIGHTFUL CONTENT EXAMINES THE RELATIONSHIPS OF HEALTH CARE SYSTEMS TO ONE ANOTHER. Discussions throughout this edition focus on how today’s systems of health care in the U.S. are both interrelated and interdependent.

  • WELL-ORGANIZED CONTENT GUIDES STUDENTS THROUGH A COMPLETE AND ENGAGING UNDERSTANDING OF HEALTH CARE IN THE U.S. This edition is organized into three primary sections that examine the origins of the country’s health care system, influences on the system and significant and recent changes to the system.

  • INTERESTING STORIES DEPICT THE CHALLENGES AND SUCCESSES OF REAL HEALTH CARE ORGANIZATIONS. The authors weave engaging, real stories from actual health care organizations into the narrative to depict how real companies are dealing with the delivery and financing of health care in the U.S. today.

  • NUMEROUS TIMELY EXAMPLES DEPICT THE IMPACT OF HEALTH CARE REFORM. The authors include current of examples that demonstrate how health care reform can and does influences the delivery and reimbursement of health care services throughout the country.

  • INSIGHTFUL DISCUSSIONS REVIEW THE ETHICAL IMPLICATIONS BEHIND HEALTH CARE IN THE U.S. This edition challenges students to explore difficult questions as the authors review the ethical implications of health care delivery today. Students examine issues ranging from end-of-life decisions to care quality, sustainability and confidentiality.

  • RECENT CONTENT EXAMINES THE LATEST HEALTH CARE TECHNOLOGY. This edition remains current with not only the latest developments in health care technology, but also how advancements in technology impact both delivery and access to health care today.

Cengage provides a range of supplements that are updated in coordination with the main title selection. For more information about these supplements, contact your Learning Consultant.

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