The federal government operates six major health care programs that serve nearly 100 million Americans. Collectively, these programs significantly influence how health care is provided by the private sector. Leadership by Example explores how the federal government can leverage its unique position as regulator, purchaser, provider, and research sponsor to improve care - not only in these six programs but also throughout the nation's health care system. The book describes the federal programs and the populations they serve: Medicare (elderly), Medicaid (low income), SCHIP (children), VHA (veterans), TRICARE (individuals in the military and their dependents), and IHS (native Americans). It then examines the steps each program takes to assure and improve safety and quality of care. The Institute of Medicine proposes a national quality enhancement strategy focused on performance measurement of clinical quality and patient perceptions of care. The discussion on which this book focuses includes recommendations for developing and pilot-testing performance measures, creating an information infrastructure for comparing performance and disseminating results, and more. Leadership by Example also includes a proposed research agenda to support quality enhancement. The third in the series of books from the Quality of Health Care in America project, this well-targeted volume will be important to all readers of To Err Is Human and Crossing the Quality Chasm - as well as new readers interested in the federal government's role in health care.

本書は政策提言の枠を超え、国家という巨大な装置が「個の命」とどう向き合うべきかを追求した、壮大な意志のマニフェストです。高齢者や子ども、退役軍人といった多様な生を背負う六つのプログラムが、単なる官僚機構ではなく、人道的な情熱を宿した変革の主体として描かれる点に、本書の真に文学的な深みがあります。 「範を垂れる」という言葉が象徴するように、権力が自らを律し、透明性という光で医療の深淵に挑む姿には、組織論を超えた高潔な美学が宿っています。システムと人間性の調和を渇望するすべての読者へ、本書は未来を切り拓くための確かな鼓動を伝えてくれるでしょう。