Book Review — Health Networks: Can They Be the Solution?

September-October 2002


Thomas P. Weil
University of Michigan Press, Ann Arbor, 2001, 344 pp., $50.

This book contains a wealth of knowledge and great insight into the past, present, and future of our health care delivery system. The question concerning health networks posed by the author in his title — can they be the solution? — is an especially interesting question in view of the fact that, as early as 1929, a group called the Committee on the Cost of Medical Care was formed to study the economic and social aspects of the delivery of health services in the United States. This committee recommended that such services be organized on a regional basis, with appropriate coordination of primary, secondary, and tertiary services. Ever since then, we seem to have been trying to put old wine in new skins, with only limited success to date.

Throughout the book, the author has a constant theme. If health networks are organized and managed appropriately for the best interest of the community, he argues, they will provide greater access, improve quality of care, reduce cost, and enhance social equity. He cautions, however, that given the size, scope of services, and market clout of some regional networks, they could become fiscally and politically powerful oligopolies and could use that power simply to enhance financial position.

This is where health care leaders and their trustees need to be mindful of the purpose of their organizations and faithful to that purpose. Weil addresses these issues in a chapter on leadership that would serve as a good resource for leadership search committees.

Any book that discusses health networks must include the requisite comparison of the U.S. health system with those of other nations. In making these comparisons, Weil focuses on the Canadian and German health care systems. He concludes that Americans' values and cultural heritage cause us to be wedded to a multipayer, pluralistic system of organizing, managing, and funding health care. Therefore, we will not see any meaningful attempt to create universal health care in the foreseeable future. We can expect more of the same three-tiered system: fee-for-service care for the wealthy, HMOs for the middle class, and continued access problems for the poor.

The book has much to offer. I enjoyed the historical context set by the author, as well as his knowledge of the various ways the economy, coupled with cultural norms, is likely to enhance or impede the development of health policy.

John T. Shea
Senior Vice President, Business Development
Bon Secours Health System
Marriotsville, MD


Copyright © 2002 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Book Review - Health Networks - Can They Be the Solution

Copyright © 2002 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.