Howard Waitzkin

Barbara Waterman

This short book presents a critical analysis of existing institutional structures in the American health system, as well as an appraisal of theory in medical sociology. In the introductory section we consider medicine as a social institution and the sociopolitical context of illness. In Section 2, after discussing previous theoretical positions in medical sociology, we outline an alternative theoretical approach. Section 3 attempts to show that the sick role, by providing a controllable form of deviance, mitigates potential conflicts in such institutions as prisons, the armed forces, and the Selective Service System; by helping prevent conflicts, the sick role reduces the probability of basic institutional change. Stratification in medicine is the topic of Section 4; the control of information is studied as a major source of medical stratification. In Section 5 we analyze the problem of empire building in American medicine, with emphasis on the major proposed reforms in the health system-national health insurance and health maintenance organizations. The study concludes with a brief discussion of the relationships between improved health care and broad sociopolitical change.

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