In our attempt to simplify our complicated healthcare system, we have tended to look at its individual components and not at the processes and interactions of the whole. The result is that we have duplicated our efforts, driven up costs, and compromised quality of care. In The U.S. Healthcare Ecosystem, Robert Burns looks (for the first time that I can tell) at the function of the system as a whole.
Rulon F. Stacey, Ph.D. FACHE
Malcolm Baldrige National Quality Award Recipient
Director of Graduate Programs in Health Administration
University of Colorado Denver
Rather than do his work from the “ivory tower” of academia, Professor Burns has spent considerable time over his illustrious career interviewing healthcare executives for field research projects and delving into conflicts between healthcare organizations through his work as an expert witness. His understanding of healthcare organizations and how they interact with patients, payers, and each other has prepared him to write a text that students will find to be highly relevant.
Director, USC-Brookings Schaeffer Initiative for Health Policy
Leonard D. Schaeffer Chair in Health Policy Studies, The Brookings Institution
Professor of Health Policy and Director of Public Policy, Schaeffer Center for
Health Policy and Economics, University of Southern California
There is no shortage of books on the U.S. healthcare “system.” While all these books provide value, they often employ a framing that does not lend itself to a more holistic “on the ground” understanding of how the healthcare system works (or doesn’t) and the important interrelationships among its various components. In this text, Burns takes advantage of his decades of business school teaching by employing a no-nonsense, business perspective on how the system operates as an ecological system. The need for such a text is great as students of health administration or business management rightfully expect material that equips them to operate in a challenging and changing industry.
Professor of Health Management and Policy, emeritus
The U.S. Healthcare Ecosystem fills a void in introductory textbooks by providing insightful analysis on how the entire healthcare industry operates. Its unique focus on processes rather than structure is revealing and instructive. The volume is comprehensive in its coverage of the many moving parts that constitute healthcare delivery, including the workforce, which makes the text valuable in courses for nurses, physicians, management, and health policy.
Linda H Aiken, Ph.D., RN, FAAN
The Claire M Fagin Professor of Nursing
Director, Center for Health Outcomes and Policy Research
University of Pennsylvania
This is an outstanding textbook, and one that we have needed for a long time. The book’s most distinctive and valuable contribution is the perspective it takes: to improve the U.S. healthcare system, we need to understand how it operates from an ecological perspective that emphasizes how a variety of key actors and systems interact with each other. In short, this book focuses on the physiology of our healthcare system, not simply its anatomy.
Wagner Graduate School of Public Service
What sets this text apart from others in the field is its focus on process—how things get done— within the current and emerging structures of the healthcare ecosystem.
Jacqueline Zinn, Ph.D., M.B.A.
Fox School of Business, Temple University
Over the past 20 years, I have taught an introductory course on the U.S. healthcare system at the undergraduate and graduate level in various settings aimed at students interested in business, medicine, nursing, public health, and public policy. This is the first textbook that covers the key actors in the healthcare system with the right balance of breadth and depth.
Bloomberg Distinguished Professor of Health Policy and Economics
Department of Health Policy and Management, Bloomberg School of Public Health
A la Clayton Christensen, Burns differentiates the appearance from the reality of innovation. He provides us with a clear, consistent, and comprehensive account of healthcare flows of money, information, products, and influence. This is “must reading” for management and business students and working professionals in all health disciplines and schools.
Professor Emeritus of Public and Health Management
Robert F. Wagner Graduate School of Public Service
The U. S. Healthcare Ecosystem is a novel text and refreshing departure from other introductory books on our healthcare industry. Students will benefit from the emphasis on the strategic decisions and processes involved as opposed to the traditional emphasis on the structure of the system.
Stephen M. Shortell, PhD, MBA, MPH
Professor of the Graduate School
Blue Cross of California Distinguished Professor of Health Policy and
Co-Director, Center for Healthcare Organizational and Innovation Research (CHOIR)
Co-Director, Center for Lean Engagement and Research (CLEAR)
Dean Emeritus, School of Public Health
Professor of Organization Behavior, Emeritus, Haas School of Business
In a field that is changing at a breathtaking pace with no signs of letting up, how much more productive it is to help students understand the actions and interactions of healthcare players than having them focus on statistics and descriptions of them that are destined to be out of date before the end of the term. Another advantage of the text is the inclusion of many areas that are not covered by other texts, since a segment of the delivery system that seems insignificant today may be driving important changes tomorrow. This was a book worth waiting for.
Cindy (Carolyn) A. Watts, Ph.D.
Department of Health Administration
College of Health Professions
Virginia Commonwealth University
I fully expect this text to become the standard in U. S. healthcare administration programs, benefiting faculty as well as students. It will be exciting to see its impact in the classroom and beyond.
James A. Hamilton Chair in Health Policy and Management
Professor, Division of Policy and Management
School of Public Health, University of Minnesota
This outstanding text describes how the U.S. healthcare industry functions as an ecosystem of complementary organizations, rather than a set of stand-alone actors. This has become all too evident during the COVID pandemic, where lack of coordination between different organizations in local and national ecosystems has damaged our ability to respond. The book describes the elements of the healthcare ecosystem, identifies the points of contact among actors, and highlights areas where we need drastic improvement.
Anthony S. Fell Chair in New Technologies and Commercialization
Academic Co-director Global Executive MBA in Healthcare and Life Sciences
Rotman School of Management, University of Toronto
Professor Burns, a seasoned observer of the U.S. healthcare industry, has written a volume of unusual breadth and depth. He includes topics that are rarely covered well in introductory courses – for example health information technology, biotechnology, and medical technology – and brings a thoughtful, critical eye to controversies of each topic.
Lawrence P. Casalino, M.D., Ph.D.
Livingston Farrand Professor of Public Health
Chief, Division of Health Policy and Economics
Department of Population Health Sciences
Weill Cornell Medical College
Robert Burns, an internationally renowned healthcare expert, has prepared an outstanding text book on the U.S. system. The book is both comprehensive and insightful as a resource for understanding why and how healthcare is currently delivered. Most impressive is the book’s elucidation of the organizational, financial, and public policy considerations that shape the way healthcare is delivered at every level of the industry. The book thoroughly covers topics that other textbooks on U.S. healthcare tend to overlook, particularly the sectors responsible for medical technology and drugs. It is really a “must read” for students pursuing careers in healthcare management and for healthcare professionals who seek a deep understanding of the world in which they work.
Gary J. Young, J.D., Ph.D.
Director, Northeastern University Center for Health Policy and Healthcare Research
Professor, D’Amore-McMim School of Business and Bouve College of Health Sciences Northeastern University
As the 45th President learned, “Nobody Knew Health Care Could Be So Complicated!” For anyone interested in a career in healthcare, it’s critical to understand all of the pieces and how they fit together—sometimes in competition, sometimes in collaboration, and seemingly always with critical relationships in flux. I know of no other volume that addresses this entire system in such a comprehensive, accessible, and informative manner.
Professor of Medicine, Stanford University School of Medicine
Professor of Economics (by courtesy), Stanford Graduate School of Business
President, Business School Alliance for Health Management
Robert Burns applies his formidable repertoire of deep and broad insights to create a highly useful guidebook for readers seeking to better understand and navigate the complexities of the largest and fastest growing industry in the U.S. With his holistic emphasis on the interactions between and among key actors, Prof. Burns provides a welcome cohesion and coherence as he expertly addresses the functioning (as well as the dysfunctioning) of our healthcare ecosystem. Bravo!
James F. Beré Professor of Management and Organizations
Kellogg School of Management
Any book that describes U.S. healthcare as a “system” must confront the evidence of variability, fragmentation, and disparities, among other challenges. Robert Burns offers a wholly different approach to understanding healthcare in America – as an ecosystem in which different actors and entities transact, innovate, provide, and produce healthcare services and products. His process analysis of how the business of healthcare actually works (or doesn’t) is a welcome addition to understanding the healthcare industry.
Professor, Health Management & Policy
Few have immersed themselves in the complex inner workings of the U.S. healthcare system like Rob Burns. This expansive yet in-depth survey of the healthcare landscape offers insights not found in typical texts. Recognizing that the U.S. system lacks structural design in its origin, Burns focuses on its evolution—how the diversity of actors have adapted under a mix of market and regulatory pressures, and how their interactions determine the care we get. The book at once applies scholarly rigor to an industry rife with slogans and grounds academic instincts in the reality of how the business works. The result is a must read for thinkers and doers alike.
J. Michael McWilliams M.D., Ph.D.
Warren Alpert Foundation Professor of Health Care Policy
Dept. of Health Care Policy