HEALTH ECONOMICS Health Econ. 8: 553–558 (1999) BOOK REVIEWS BOOK REVIEWS The Health Care Marketplace by WARREN GREEN- BERG. Springer-Verlag, New York, 1998. No. of pages 170. ISBN 0-387-98457-7. This book examines various facets of the US health care industry in terms of the incentives that exist in them and the responses these have provoked. It is written largely for an American audience versed in economics but will be of interest to those outside the US as well as those outside the discipline. It is com- prized of 11 chapters, through which the reader is propelled like a well greased toboggan. In Chapter 1, the size of the health economy is described and some basic economic concepts introduced. Rounding a hair- pin into Chapters 2 and 3, we thunder through the physician and hospital service sectors before the role of insurance and HMOs in health care fly past in Chap- ters 4 and 5. We are allowed to catch our breaths, somewhat, in Chapter 6 and 7—where the role of Medicare and Medicaid and the size, structure and peculiarities of the long-term care sector are discussed (respectively) — before attempts to promote competi- tion in health care are dealt with in Chapter 8. We hurtle through government regulation in Chapter 9 and with the home straight almost in sight, Chapter 10 takes us over technology advances, costs and the need for non-price rationing. Finally in Chapter 11, the white knuckle ride ends with a review of the organiza- tion and financing of health care in Canada, Israel and the Netherlands, and how the US might learn from these. What did I think of the book? Well it begins by asserting that ‘The health care industry . . . is not much different in economic terms from other industries’ and concludes that ‘ . . . the greater concern in this industry over the ‘correct’ distribution of services separates the analysis of (it) from many others.’ In between the difficulty with both positions becomes apparent. In places it is informative and compelling. When describing responses elicited to economic incentives (e.g. Chapter 8) or how incentives have helped shape particular sectors (e.g. Chapter 7), the underlying thesis of the book—that health care is not much different in economic terms from other industries — was both en- gaging and convincing. Similarly, the case studies pre- sented at the end of several chapters are both interesting and valuable in impressing on the reader, the human consequences of, for example, cost contain- ment. In seeking to describe an entire health care system, as well as the operation, growth and failings of that system, the book is, however, overly ambitious in its scope. At times the amount of descriptive detail pro- vided — especially for those not familiar with the struc- ture of the US system—and the brevity with which this is described is more likely to bewilder rather than inform. On other occasions inadequate detail for the reader to assess the assertions of the author is pre- sented — the Clinton Health Care Reform Plan, for example, is described, analysed and dispatched as hav- ing rested on unsound theory in five short paragraphs. Detailed referencing is provided for those interested in examining issues in greater depth, it is true, but this is a poor substitute for a fuller treatment of the material in situ. Similarly, while the author endeavours to minimize his use of economic terminology, I am not convinced that the material presented will always be readily com- prehensible to the non-economist. (For example, no explanations of ‘crowding out’ or of a Herfindhal in- dex are provided.) Indeed on several occasions argu- ments are presented with such brevity as to require some hard thinking by an economist before their ratio- nale can be inferred. Finally, in dealing with insights from other coun- tries, with the exception of the Netherlands, whose reforms the author describes in such glowing terms as to leave one wondering why other systems have not rushed to follow suit, what the US can learn from anyone else is unclear. Moreover, there is no mention as to how one would overcome the various interest groups (convinced of the superiority of the US system no doubt), which have stymied reform in the US, so as to benefit from these lessons. Perhaps convincing the- ory will be enough to win the day. Overall I enjoyed reading this book and would rec- ommend others to read if they have the time. It is not, however, a book which I would recommend others to make the time to read. CIARAN O’ NEILL Trent Institute for Health Serices Research, Queen’s Medical Centre, Nottingham NG72UH, UK CCC 1057–9230/99/040553 – 06$17.50 Copyright © 1999 John Wiley & Sons, Ltd.