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Differential Diagnoses: A Comparative History of Health Care Problems and Solutions in the United States and France (The Culture and Politics of Health Care Work) 1st Edition

4.4 out of 5 stars 5 customer reviews
ISBN-13: 978-0801474842
ISBN-10: 0801474841
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Editorial Reviews

Review

"The health care systems of France and the United States began the 20th century looking very much alike, then gradually moved in different directions while retaining a surprising number of common features. Dutton believes that both countries would benefit from taking a careful look at their similarities and differences. Both systems utilize a public/private mix of financing, maintain the fee-for-service basis for physician reimbursement, and hold out the ideals of physician practice autonomy and patient choice of doctor. Dutton says that the United States is almost inadvertently expanding coverage but with little planning; at the same time, the French are adapting U.S. managed-care techniques in an attempt to keep down costs and improve efficiency in a system already offering universal coverage. . . . This distinctive, readable, and well-organized history is recommended for public and academic libraries, especially where health-care reform is a hot topic."―Library Journal

"In Differential Diagnoses Paul V. Dutton tells the story of two nations over the course of an entire century. This remarkable book is one part history, one part policy analysis, and it is held together by strong conceptual glue. Differential Diagnoses is distinguished by Dutton's smooth, jargon-free writing, its accessibility, its richness of anecdote, its blending of original archival research with synthetic research drawn from several disciplines, and its timely and level-headed diagnosis and prescriptions for change."―Timothy B. Smith, Queen's University

"Paul Dutton exhibits superb scholarship and insight on the evolution of health care financing and organization in France and the United States. His lucid book demonstrates that France's health system is more relevant for the United States than the health systems of the usual suspects―Canada, Germany, and Britain. It should be read by all health policy analysts, scholars, and social reformers who are searching for ways to achieve universal health insurance coverage in the United States."―Victor G. Rodwin, Professor of Health Policy and Management, Wagner/NYU; and Director, World Cities Project, International Longevity Center-USA

"By first exposing the stereotypes and then carefully exploring the distinct histories of health care provision in the United States and France, Paul Dutton provides unique and valuable insight into how both countries can better address their respective health crises."―Jeremy Shapiro, Fellow and Director of Research, Center on the United States and Europe, The Brookings Institution

From the Back Cover

"In Differential Diagnoses Paul V. Dutton tells the story of two nations over the course of an entire century. This remarkable book is one part history, one part policy analysis, and it is held together by strong conceptual glue. Differential Diagnoses is distinguished by Dutton's smooth, jargon-free writing, its accessibility, its richness of anecdote, its blending of original archival research with synthetic research drawn from several disciplines, and its timely and level-headed diagnosis and prescriptions for change."--Timothy B. Smith, Queen's University

"Paul Dutton exhibits superb scholarship and insight on the evolution of health care financing and organization in France and the United States. His lucid book demonstrates that France's health system is more relevant for the United States than the health systems of the usual suspects--Canada, Germany, and Britain. It should be read by all health policy analysts, scholars, and social reformers who are searching for ways to achieve universal health insurance coverage in the United States."--Victor G. Rodwin, Professor of Health Policy and Management, Wagner/NYU; and Director, World Cities Project, International Longevity Center-USA

"By first exposing the stereotypes and then carefully exploring the distinct histories of health care provision in the United States and France, Paul Dutton provides unique and valuable insight into how both countries can better address their respective health crises."--Jeremy Shapiro, Fellow and Director of Research, Center on the United States and Europe, The Brookings Institution

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Product Details

  • Series: The Culture and Politics of Health Care Work
  • Paperback: 272 pages
  • Publisher: ILR Press; 1 edition (October 30, 2008)
  • Language: English
  • ISBN-10: 0801474841
  • ISBN-13: 978-0801474842
  • Product Dimensions: 6 x 0.2 x 9 inches
  • Shipping Weight: 12.8 ounces (View shipping rates and policies)
  • Average Customer Review: 4.4 out of 5 stars  See all reviews (5 customer reviews)
  • Amazon Best Sellers Rank: #1,344,541 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Joel A. Harrison on January 2, 2008
Format: Hardcover
Once again with an upcoming election health care shows itself a major concern of the American people. Health care costs are soaring, the ranks of the uninsured and underinsured are increasing, over 50% of bankruptcies are due to medical expenses and employers are dropping coverage. Not only is our system the most expensive by far in the world; but the most complex and bureaucratic. Its costs affects the competitiveness of American firms on the world market and people often seek or retain jobs based on availability of health insurance rather than matching skills and interests, thus lowering productivity. Polls show the American people want change and see the Canadian single-payer system as a model. However, not too long ago the World Health Organization ranked the health care system of France as number 1 with the U.S. in 37th place, something unknown to most Americans until Michael Moore's recent film, Sicko.

So why not consider French health care as a possible system to model after rather than Canada ? For many, the answer is obvious. Americans would never tolerate "socialized" medicine. But is France 's health care "socialized medicine?" Paul V. Dutton's timely book answers this question with a resounding, NO! It turns out that no other country on the face of this earth has as similar 18th Century liberal values of individual freedoms and responsibility to those of the U.S. as France and it shows in their health care system. "Socialized Medicine" is for the French as anathema as it is to us. Yet France has managed to attain universal coverage, high quality medicine, and no waiting lines in a system of private fee-for-service medicine that Americans could only dream about and at lower cost.
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Format: Hardcover Verified Purchase
This is a useful book. Like another reviewer, I wish the author had included a more thorough description of the present French system. My understanding is that electronic medical records, to some extent at least, are embedded in the health care card carried by members. When they visit a doctor's office, a swipe of the card in the reader, conveys some information (I wish I knew how much) to the doctor's office record and, at the same time, deposits the Securite Sociale payment in his practice account. It is interesting to see how much the French have preserved the private fee-for-service system. The author decries this a bit, emphasizing the risk of excessive utilization in the fee-for-service system. That is definitely true but the prepaid system of the HMO has the mirror-image risk of denying service to reduce expense. Buyers of new home prepaid service plans know how difficult it can be to get the service technician to come out to fix the dishwasher when he has already been paid.

The parallel history format of the book is good and, while I am very familiar with the history of US health care, it was valuable to see the contrast with the French system. The unique circumstance that had a lot to do with the diversion of the French system from ours was the loss to Germany in 1940 and the subsequent period of Vichy rule. All the older structures of government and the hierarchy of the medical profession were upset and replaced by a diluted version of the Nazi regime. The 1944 invasion and liberation placed the De Gaulle organization in charge and it was very interesting to learn that health care reform was a concern of the Free French even during the period of exile from 1940 to 1944.
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Format: Hardcover
Bring up anything French to most Americans, and one gets jokes, frowns, insults and other demeaning comments. Whether it be French fries, Americans winning the Tour de France, or French women, Americans tend to look down on France. This is regrettable, as many aspects of French history have paralleled events in American history. This book by Professor Dutton at the University of Arizona examines the evolution of the medical systems in France and America over the course of the 20th century. Specifically, the book looks at the economics and politics of health care in both countries; such as major laws and regulations, the role of third-party insurers, the role of employer-based health care, conflicts between doctors and hospitals, and the unending debate over private fee-for-service and socialized medicine. Surprisingly, the debates in the US on all these issues have paralleled those in France, often occurring in the same decade. The book is written in chronological order, and reads like a history book. The text is readable by those inside and outside the medical community, and requires almost no economic or medical knowledge to understand. Given the topic, this book is very good and informative, and quite unique in providing an in-depth comparison of two countries.

The book does have two drawbacks. First is the minimal coverage it gives of medical education in the two countries. This is very important, and might help the reader understand how paths have diverged in the two countries. Second, the book focuses almost entirely on doctors; little mention is made of nurses, pharmacists, dentists, and the vast community of scientists and supporting staff who are responsible for research and development. For these two drawbacks I give the book three stars, and not five.
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