Healthy Markets?: The New Competition in Medical Care

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Overview

When federal and state policy makers' efforts to enact sweeping health care reform in the mid-1990s ended in stalemate, the private sector unleashed initiatives that have affected virtually every aspect of health care. With updated essays first published in issues of the Journal of Health Politics, Policy and Law, Healthy Markets? offers the most comprehensive and critical examination yet found in a single volume of the economic, political, and social implications of this recent market transformation of health care in the United States.

With original contributions from leading social science health policy analysts, this volume addresses the full context of health system change. Believing that the analysis of health care change is too important to be left to economists alone, Mark A. Peterson has collected a mulitdisciplinary group of experts who revisit the contentious debate over the market approaches to health care and consider the disparate effects of these approaches on cost, quality, and coverage of both managed care and Medicaid and Medicare. While market enthusiasts applaud the enhanced efficiency, reduced excess capacity, and abatement of the decades-long health care cost explosion, a backlash has emerged among many providers and the public against the perceived excesses of the market: diminished access to care, commercialization of the physician-patient relationship, and exacerbated inequality. Contributors assess these varied responses while examining the impact that market-based applications are likely to have for future health policy making, the significance of the U.S. experience for policy makers abroad, and the lessons that these changes might provide for thinking sensibly about the future of our health care system.

This volume will be useful for public policy analysts, economists, social scientists, health care providers and administrators, and others interested in the future-and in understanding the past-of American health care.

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Editorial Reviews

From the Publisher
Healthy Markets? does what we always want and rarely get in an edited volume: combine the different perspectives of many fine scholars into a whole that is greater than the parts. The essays are sometimes contentious, often brilliant, and always illuminating. They add up to a rich assessment both of health policy in the mid-1990s and of the forces that will determine what happens next.”—Joseph White, Tulane University Medical Center

“This timely and insightful volume presents an invaluable road-map to understanding the turbulent American health care market at the turn of the twenty-first century. It draws together leading academic observers of the health care arena to address both intellectual disputes and practical experience in a matchless set of contributions.”—Carolyn Hughes Tuohy, University of Toronto

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Product Details

  • ISBN-13: 9780822322368
  • Publisher: Duke University Press
  • Publication date: 3/28/1999
  • Pages: 439
  • Lexile: 1470L (what's this?)
  • Product dimensions: 6.44 (w) x 9.58 (h) x 1.28 (d)

Meet the Author

Mark A. Peterson is Associate Professor of Public and International Affairs, Political Science, and Health Services Administration at the University of Pittsburgh. He is the editor of the Journal of Health Politics, Policy and Law and author of Legislating Together: The White House and Capitol Hill from Eisenhower to Reagan.

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Table of Contents

Introduction: Health Care into the Next Century 1
Pt. 1 The Market Model 25
Can Markets Give Us the Health System We Want? 27
Going for the Gold: The Redistributive Agenda behind Market-Based Health Care Reform 66
Commentary
Who Was That Straw Man Anyway? A Comment on Evans and Rice 104
Commentary
What Does Economics Have to Say about Health Policy Anyway? A Comment and Correction on Evans and Rice 110
Response
A Reply to Gaynor and Vogt, and Pauly 129
Response
Coarse Correction - And Way off Target 134
The Technocratic Wish: Making Sense and Finding Power in the "Managed" Medical Marketplace 140
The Doctor as Businessman: The Changing Politics of a Cultural Icon 161
Pt. 2 The Market in Practice 183
The Dynamics of Market-Level Change 185
The Health System in Transition: Care, Cost, and Coverage 203
Markets, Medicare, and Making Do: Business Strategies after National Health Care Reform 223
Managed Care and Medicare Reform 255
Markets and Medicaid: Insights from Oregon and Tennessee 284
Pt. 3 Reflections on the Road Ahead 317
The Limits of Social Learning: Translating Analysis into Action 319
Exceptionalism as the Rule? U.S. Health Policy Innovation and Cross-National Learning 353
Forecasting American Health Care: How We Got Here and Where We Might Be Going 367
Bibliography 387
Contributors 425
Index 427
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