New in the fourth edition:

• An update on the changes to Medicare coverage, including adding means testing on optional coverage for beneficiaries
• A new discussion of the legislation the current administration would like to implement for universal healthcare coverage
• A new focus on the quality-of-care debate and pay-for-performance incentives
• New requirements for not-for-profit hospitals to report services provided in order to validate their tax status
• An update on managed care and how universal coverage could change payment and delivery
• Updated information on biomedical research and the debate on whether the United States will remain a leader on this effort
• A new discussion of the effects of the current economic downturn on healthcare
• An updated discussion on the status of the healthcare workforce and how nursing and possible physician shortages will affect our system
• A discussion on healthcare expenditures and the estimated 47 million people who are currently uninsured
• A master bibliography has been created and is now located at the back of the book
• Updated glossary and acronym list