Michael K. Gusmano – författare

How are four major world cities coping with the challenges posed by increasing human longevity and population aging? Top researchers, scholars and policymakers compare what it is like to grow older in New York, London, Paris, and Tokyo with respect to health and quality of life, living arrangements and housing, and the provision of long-term care to older persons when they eventually become frail.

How are four major world cities coping with the challenges posed by increasing human longevity and population aging? Top researchers, scholars and policymakers compare what it is like to grow older in New York, London, Paris, and Tokyo with respect to health and quality of life, living arrangements and housing, and the provision of long-term care to older persons when they eventually become frail.

How financial profiteering has reshaped long-term care and jeopardized the well-being of nursing home residents.Nursing homes care for some of the nation's most vulnerable citizens. They are also increasingly controlled by financial actors whose priorities lie far from the bedside. In Financialization of the US Nursing Home Industry, Laura Katz Olson and Michael K. Gusmano examine how for-profit companies—and increasingly private equity firms and real estate investment trusts (REITs) with complex ownership structures—have transformed long-term care into a vehicle for profit extraction.Drawing on extensive case studies of major chains and mid-sized operators, the authors trace the industry's consolidation over decades and document how financial engineering—asset stripping, related-party transactions, real estate manipulation, and deliberate labor cost cutting—has reshaped nursing home operations. Chronic understaffing, declining care quality, opaque ownership arrangements, and repeated bankruptcies plague a system designed to maximize returns. The book places these developments in historical and policy context, showing how federal and state government policies enabled substandard conditions even as public funds—primarily Medicare and Medicaid—now supply roughly three-quarters of industry revenue. The COVID-19 pandemic exposed long-standing systemic obstacles to decent care, revealing how financial priorities can have deadly consequences for residents and frontline caregivers alike.This essential book offers scholars, policymakers, students, and advocates a comprehensive account of how the nursing home industry works—or doesn't work—and why meaningful reform will require structural change. Care for powerless older people, the authors argue, must be treated as a public responsibility rather than a private investment strategy.

This book analyzes policy fights about what counts as good evidence of safety and effectiveness when it comes to new health care technologies in the United States and what political decisions mean for patients and doctors.Medical technologies often promise to extend and improve quality of life but come with many questions: Are they safe and effective? Are they worth the cost? When should they be allowed on the market, and when should Medicare, Medicaid, and private insurance companies be required to pay for drugs, devices, and diagnostic tests? Using case studies of disputes about the value of mammography screening; genetic testing for disease risk; brain imaging technologies to detect biomarkers associated with Alzheimer's disease; cell-based therapies; and new, expensive drugs, Maschke and Gusmano illustrate how scientific disagreements about what counts as good evidence of safety and effectiveness are often swept up in partisan fights over health care reform and battles among insurance and health care companies, physicians, and patient advocates. Debating Modern Medical Technologies: The Politics of Safety, Effectiveness, and Patient Access reveals stakeholders' differing values and interests regarding patient choice, physician autonomy, risk assessment, government intervention in medicine and technology assessment, and scientific innovation as a driver of national and global economies. It will help readers to understand the nature and complexity of past and current policy disagreements and their effects on patients.