Calling the book a "tool kit and design manual," the authors have set out an ambitious plan for policymakers who want to improve health care for people in their countries, especially for the most vulnerable in society. Believing first and foremost that health is a "component of both opportunity and well-being for all individuals in society," the authors outline a detailed plan for analyzing the stumbling blocks to quality health care in any given society, and then for designing routes around those roadblocks that meet the ethical, cultural, financial and political realities of the society and the situation.

Real-life examples are plentiful: regional governments in Poland decided to finance hospitals in large cities after the fall of Communism, only to return the responsibility back to the national government after costs ran high (Some of the book’s authors and Flagship course faculty were later involved in a lengthy health sector reform project in Poland); a number of African governments are trying to deal with increasing inequities between local health services after systems were decentralized; the Bangladeshi government attempted health policy reform several years ago, only to crumble in large part due to opposition from a physicians’ association.

"Health sector reform, we believe, is an arena in which intelligence, energy, passion and critical thinking can make a difference," write the authors. "It offers opportunities for leadership and craftsmanship, for doing work that is truly worth doing."

The textbook draws on the vast experience of the authors–-all prominent academic researchers who have advised governments and NGOs–-as well as from participants who brought their own expertise to previous Flagship courses.

Advice is well-documented and often intriguing. For example, the book advises policymakers to be scientifically rigorous in analyzing the root of a problem. At the same time, the authors encourage vociferously that policymakers should embrace politics, a field in which factors such as personal relationships and public image may play roles as influential as hard facts in achieving goals.

"Reform will strengthen some interest groups and weaken others," write the authors, "and groups will seek to influence the implementation and redesign of reform policies." The authors urge reformers to analyze the ethical dimensions of health reform, while accepting the reality–and muscle–of political processes. "New external shocks will occur, changing both the reality and the public perceptions of the problems each nation faces … [you must] redo [the] political analyses as the reform process moves forward," they write.

-PHC

Escape Fire: Designs for the Future of Health Care

By Donald Berwick, President and CEO, Institute for Health Care Improvement, and Professor in the Department of Health Policy and Management

Publisher: Jossey-Bass, 2003

Escape Fire: Designs for the Future of Health Care features 11 speeches delivered by Berwick at the Institute for Healthcare Improvement’s annual National Forum on Quality Improvement in Health Care over the past decade. The speeches reflect a theme that the American health care system needs fundamental changes and a revolutionary new design. Berwick identifies lessons for those changes from varied sources–a girls’ soccer team, a sinking ship and the safety standards at NASA.

The book’s title is taken from the 1949 Mann Gulch tragedy in which 13 young firefighters were trapped in a wildfire on a Montana hillside. The firefighters’ leader, Wag Dodge, devised a creative solution for avoiding the encroaching fire. He burned a patch of grass and lay down in the middle of the scorched earth. His team refused to join him, and most perished in the fire. Dodge survived. Berwick applies the lessons learned from the catastrophe to the American health care system–ingrained processes must not obstruct life-saving innovation, he asserts.

–Copy based on material available at http://www.ihi.org/store/Escape-fire.asp.

Managing Health: An International Perspective

By Nancy Kane, Professor of Health Policy and Management, and Nancy Turnbull, Lecturer on Health Policy

Publisher: Jossey-Bass, 2003

Managing Health: An International Perspective provides students and professionals with a global point of view on tools and mechanisms that have been used to manage the health care of populations. Featured are 11 teaching cases based on original research by Kane and Turnbull that are designed to gain a deeper understanding of the challenges of health care reform. The book offers insights into the roles played by many stakeholders in the health care system: government, employers, insurers, providers, suppliers and consumers.

–Copy based on material available at http://www.josseybass.com/WileyCDA/WileyTitle/productCd-0787968994.html.

Guide to Producing National Health Accounts: With Special Applications for Low-Income and Middle-Income Countries

Edited by Peter Berman, Professor of Population and International Health Economics, et al.

Publisher: World Health Organization, 2003

The World Bank, World Health Organization and USAID partnered to produce the Guide to Producing National Health Accounts. The book offers the collective expertise of seasoned practitioners. They provide insight into how to evaluate and restructure national health care financing systems, as well as how to develop and assess financial interventions to improve a population’s health.

–Copy based on book jacket.