The Economic Evolution of American Health Care: From Marcus Welby to Managed Care

The Economic Evolution of American Health Care: From Marcus Welby to Managed Care

by David Dranove
     
 

ISBN-10: 0691102538

ISBN-13: 9780691102535

Pub. Date: 09/23/2002

Publisher: Princeton University Press

The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and

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Overview

The American health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician—epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name—who disappeared with the growth of managed care. Dranove guides consumers in understanding the rapid developments of the health care industry and offers timely policy recommendations for reforming managed care as well as advice for patients making health care decisions.

The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today. It also reflects on how difficult it is for patients to shop for medical care. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals—a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs. Newly emerging MCOs have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients.

Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. Dranove, however, believes that market forces can eventually achieve quality care and cost control. But first, MCOs must improve their ways of measuring provider performance, medical records must be made more complete and accessible (a task that need not compromise patient confidentiality), and patients must be willing to seek and act on information about the best care available. Dranove argues that patients can regain confidence in the medical system, and even come to trust MCOs, but they will need to rely on both their individual doctors and their own consumer awareness.

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Product Details

ISBN-13:
9780691102535
Publisher:
Princeton University Press
Publication date:
09/23/2002
Edition description:
Reprint
Pages:
211
Sales rank:
1,022,884
Product dimensions:
6.00(w) x 9.10(h) x 0.60(d)

Table of Contents

Acknowledgments vii

Introduction 3

Part One: The Rise of Managed Care 5

Chapter 1. Marcus Welby Medicine 7

Chapter 2. The Origins of Managed Care 28

Chapter 3. The Government Steps In 45

Chapter 4. Managed Care Takes Over 65

Part Two: The Modern Health Economy 91

Chapter 5. The Business of Health Care 93

Chapter 6. Merger mania 115

Chapter 7. Quality 136

Chapter 8. Fulfilling the Promise of managed Care 159

Notes 177

Bibliography 193

Index 203

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