This fifth edition of Our Unsystematic Healthcare System explores important debates and offers a comprehensive synopsis of health care delivery in the US. Chapter 1 begins by posing questions about life expectancy and health care costs in the US compared to other countries. Similar to the fourth edition, this edition explores the Affordable Care Act but expands the discussion to include the polarizing public health efforts to prevent the spread of COVID-19 and the political and social turmoil caused by overturning Roe v. Wade (1973) in 2022. In the discourse about health insurance, occupations, and hospital systems, Budrys presents the complexities of reimbursement formulas and the havoc that network consolidation is causing. She warns how consolidation poses a serious threat to American health care arrangements. The fifth edition includes a new chapter on the pharmaceutical industry, which explores why big pharma has become the most reviled arena in health care today. The final chapter ("Determinants of Health") delves into how personal choices regarding diet, exercise, and sleep impact health, examining the WHO’s view that neither behavior nor health care arrangements are responsible for people’s health. Recommended. General readers through faculty; professionals.

Choice Reviews

Our Unsystematic Healthcare System is a must-read for anyone interested in how the organizational structure of the healthcare system affects the health of the people it is intended to serve. I’ve used this book since I started teaching. It is comprehensive, yet accessible to a wide audience.

Mitchell Peck, University of Oklahoma

Budrys' Our Unsystematic Healthcare System is timely, informative, logical, and strikes a perfect balance between conversational and academic writing. Useful to students, professors, and the broader public, it is my favorite text for medical sociology classes, and it should be required reading for policy makers.

Eric Vogelsang, California State University: San Bernardino

With a writing style that encourages an active learning environment, Budrys offers students from a range of academic backgrounds in-depth exposure to the complexities of the American healthcare system.

Duane Matcha, Siena College

Our Unsystematic Healthcare System fills a niche not addressed by other introductory texts about the health care system of the United States. Budrys provides an accessible narrative that illuminates both social and historical influences on the extant system. I have used her texts for 13 years. This book enriches the discussion about our problematic approach to care by offering explanations and carefully integrates the effects of private sector strategies and the context of the social determinants of health.

Richard Dozal-Lockwood, Portland State University

Budrys once again uses academic storytelling at its finest by weaving together the complex interplay of healthcare stakeholders, social systems, and public policy – while carefully acknowledging the essential context of U.S. history, culture, and values. The fifth edition of Our Unsystematic Healthcare System boasts a new section exploring the story of the U.S. pharmaceutical industry that describes key influences and processes that have resulted in the current problem of high drug prices. As a pharmacy educator, I can attest that it is rare to find a source on this topic with a concise explanation of the interaction between public and private sectors on research/discovery, patents, intermediary organizations, as well as the ethics and influence of marketing and lobbying. Overall, this text is both accessible to novices as well as professionals looking to widen their perspectives on the how’s and why’s of the U.S. healthcare system.

Andrea L. Kjos, Drake University