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In Sickness and in Wealth

, 472 pages
January 1999



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In Sickness and in Wealth

American Hospitals in the Twentieth Century

American hospitals are unique: a combination of public and private institutions that are at once charities and businesses, social welfare institutions and icons of U.S. science, wealth, and technical achievement. In Sickness and in Wealth helps us understand this huge and often contradictory "industry" and shows that throughout this century the voluntary not-for-profit hospitals have been profit-maximizing enterprises, even though they have viewed themselves as charities serving the community. Although our hospitals have provided the most advanced medical care for acutely sick and curable patients, they have been much less successful in meeting the needs of the chronically ill and the socially disadvantaged. That, Stevens concludes, is the next urgent task of social policy.

Rosemary Stevens is the Stanley I. Sheerr Professor in the Department of History and Sociology of Science at the University of Pennsylvania. She is the author of American Medicine and the Public Interest.

"Stevens brilliantly views the hospital as a prism of the values and mores of society... She sees the stratification of the hospital population into private, semi-private, and charity patients as a manifestation of the social stratifications of American society."

"For me, personally, the book constituted an invitation to rethink the relationship—warts and all—among the benevolent, charitable, and business missions of the hospital, while at the same time disabusing me of my inclination to cite history to support or defend a view I might otherwise have preferred to hold."

"This book is beautifully written... and is must reading for anyone involved in the current debate on health policy. It will also make delightful reading for those who merely wish to view the shifting social and economic climate in modern America, as seen from the perspective of the hospital."

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