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The Private Regulation Of American Health Care

Author: Betty Leyerle
Publisher: Routledge
ISBN: 1315287358
Size: 27.93 MB
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This work discusses a transformation of health care delivery that was launched by coalitions of business leaders during the early 1970s. It argues for a single-payer system and considers how public regulation offers the possibility of democratic participation in setting health care policies.

Health Care Regulation In America

Author: Robert I. Field
Publisher: Oxford University Press, USA
ISBN: 0195159683
Size: 14.97 MB
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Regulation shapes all aspects of America's fragmented health care industry, from the flow of dollars to the communication between physicians and patients. It is the engine that translates public policy into action. While the health and lives of patients, as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. Government agencies at the federal, state, and local levels direct portions of the industry, but hundreds of private organizations do so as well. Some of these overseers compete with one another, some conflict, and others collaborate. Their interaction is as important to the provision of health care as are the laws and rules they implement. Health Care Regulation in America is a guide to this regulatory maze. It succinctly recaps the past and present conflicts that have guided the oversight of each industry segment over the past hundred years and explains the structure of regulation today. To make the system comprehensible, this book also presents the sweep of regulatory policy in the context of the interests, values, goals, and issues that guide it. Chapters cover the process of regulation and each key area of regulatory focus - professionals, institutions, financing arrangements, drugs and devices, public health, business relationships, and research. In a uniquely American way, the system thrives on confrontation between competing interests but survives by engendering compromise. Robert Field shows that health care regulation is an inexorable force that nurtures as well as restricts the enterprise of American health care. For the student, practitioner, executive, policy analyst, or concerned citizen, this book is an invaluable guide to the policy, politics, and practice of an industry that directly touches us all.

Regulating Healthcare

Author: Walshe, Kieran
Publisher: McGraw-Hill Education (UK)
ISBN: 0335210228
Size: 80.12 MB
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Healthcare organizations in the UK and the USA face a growing tide of regulation, accreditation, inspection and external review, all aimed at improving their performance. In the US, over three decades of regulation by state and federal government, and by non-governmental agencies, has created a complex, costly and overlapping network of oversight arrangements for healthcare organizations. In the UK, regulation of the government-run National Health Service is central to current health policy, with the creation of a host of new national agencies and inspectorates tasked with overseeing the performance of NHS hospitals and other organizations. But does regulation work? This book: . explores the development and use of healthcare regulation in both countries, comparing and contrasting their experience and drawing on regulatory research in other industries and settings . offers a structured approach to analysing what regulators do and how they work . develops principles for effective regulation, aimed at maximising the benefits of regulatory interventions and minimising their costs Regulating Healthcare is aimed at all with an interest or involvement in health policy and management, be they policy makers, healthcare managers or health professionals. It is particularly suitable for use on postgraduate health and health-related programmes.

One Nation Uninsured

Author: Jill Quadagno
Publisher: Oxford University Press
ISBN: 9780198036388
Size: 12.70 MB
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Every industrial nation in the world guarantees its citizens access to essential health care services--every country, that is, except the United States. In fact, one in eight Americans--a shocking 43 million people--do not have any health care insurance at all. One Nation, Uninsured offers a vividly written history of America's failed efforts to address the health care needs of its citizens. Covering the entire twentieth century, Jill Quadagno shows how each attempt to enact national health insurance was met with fierce attacks by powerful stakeholders, who mobilized their considerable resources to keep the financing of health care out of the government's hands. Quadagno describes how at first physicians led the anti-reform coalition, fearful that government entry would mean government control of the lucrative private health care market. Doctors lobbied legislators, influenced elections by giving large campaign contributions to sympathetic candidates, and organized "grassroots" protests, conspiring with other like-minded groups to defeat reform efforts. As the success of Medicare and Medicaid in the mid-century led physicians and the AMA to start scaling back their attacks, the insurance industry began assuming a leading role against reform that continues to this day. One Nation, Uninsured offers a sweeping history of the battles over health care. It is an invaluable read for anyone who has a stake in the future of America's health care system.

American Health Care

Author: Roger D. Feldman
Publisher: Transaction Publishers
ISBN: 9781412816939
Size: 16.96 MB
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President Clinton's health care reform proposals of 1993 represented the most far-reaching program of social engineering attempted in the United States since the passage of Medicare and Medicaid in 1965. Under the guise of reforming the health care system, the Clinton plan would have herded almost all Americans under age sixty-five into large, government-sponsored health insurance purchasing alliances that would have contracted with insurers to offer a standard set of benefits at regulated prices. The plan came under fire from both Republicans and Democrats, including moderates from both parties, but it soon became apparent that what doomed it was a public unwilling to trust government to manage their health care. The critical literature has failed to offer a cogent analysis of why government control of health care does not work. American Health Care delivers that analysis. This volume examines why untoward consequences usually follow when government sets out to do good things. The contributors demonstrate how hospital rate regulation raises hospital prices, that "no-fault" medical malpractice increases the occurrence of faulty medicine, and that FDA regulation is a major cause for the escalating cost of new drugs. Part 1, trace the genesis of Medicare and its later developments and argue the consumer advantages of medical savings accounts and written health contracts. Part 2, explore the fallacies of antitrust policies that serve the interests of competitors, attack community rating for making health insurance unaffordable to large numbers of young workers. Part 3, contains a powerful critique of the FDA for withholding vital information on the health benefits of aspirin and shows how HMOs and other plans have caused pharmaceutical marketing to shift its focus from medical effectiveness to cost effectiveness. The final section explores how the private sector is improving in the areas of regulating physician and other health professional fees and the supply and quality of health professionals. American Health Care proposes reasonable balances between government and market options for in supply of health services. Without denying the need for some governmental action, the contributors show how far the market can go farther in performing critical functions in the health care industry. This volume will be important reading for health policymakers, economists, and health care professionals. Roger Feldman is professor at the Institute for Health Services Research, University of Minnesota. Mark V. Pauly is professor in the Department of Health Care Systems of the Wharton School, University of Pennsylvania.

Protecting American Health Care Consumers

Author: Eleanor DeArman Kinney
Publisher: Duke University Press
ISBN: 0822383535
Size: 50.35 MB
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Despite the attention to the problem of protecting the health care interests of Americans, there is little consensus on what should be done politically or otherwise to address this problem. In Protecting American Health Care Consumers Eleanor DeArman Kinney, a nationally regarded expert on health policy and law, tackles the serious and ongoing debate among state and federal policymakers, health care providers, third-party payers, and consumers about how to provide procedural justice to patients in the present health care climate. To promote and ensure consumer protection in an increasingly adversarial and complicated health-care culture, Kinney first analyzes the procedures by which consumer concerns are presently discerned and resolved and then explains why these systems are unsatisfactory. She also discusses problematic procedures for making coverage policy and quality standards and proposes reforms in a variety of processes that would enable all consumers, including the uninsured, to influence key policies and standards and also to raise concerns and obtain appropriate remedies. As the first comprehensive treatment of administrative procedures in American health plans and other such institutions, Protecting American Health Care Consumers will be welcomed by state and federal policymakers, managed care executives, and lawyers charged with designing and implementing protections for consumers in public and private health plans.

Doctors And The State

Author: David Wilsford
Publisher: Duke University Press
ISBN: 9780822310921
Size: 38.91 MB
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All advanced health care systems face severe difficulties in financing the delivery of today's sophisticated medical care. In this study David Wilsford compares the health systems in France and the United States to demonstrate that some political systems are considerably more effective at controlling the cost of care than others. He argues that two variables--the autonomy of the state and the strength and cohesiveness of organized medicine--explain this variance. In France, Wilsford shows, the state is strong in the health policy domain, while organized medicine is weak and divided. Consequently, physicians exercise little influence over health care policymaking. By contrast, in the United States the state is weak, the employers and insurers who pay for health care are fragmented, and organized medicine is strong and well financed. As a result, medical professionals are able to exert a greater influence on policymaking, thus making cost control more difficult. Wilsford extends his comparison to health care systems in the United Kingdom, West Germany, Italy, Canada, and Japan. Whether the private or public sector finances health care, he discovers, there is now an important trend in all of the advanced industrial countries toward controlling escalating costs by curbing both the medical profession's clinical autonomy and physicians' incomes.

American Health Care Blues

Author: Irwin Miller
Publisher: Transaction Publishers
ISBN: 9781412816946
Size: 11.76 MB
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Making novel use of the sociology of organizations and pragmatic philosophy, Irwin Miller sheds new light on the nature and evolution of both the Blues and American health care voluntarism and reform. He shows how Walter McNerney, one of the primary health policy shapers over the past forty years, used ideological and utopian rhetoric to help move Blue Cross into HMO development. This case study of institutional and leadership behavior uses firsthand interviews, archival documents, oral histories, and other materials to present an unusually concrete and readable narrative account as to how health care leaders engage in creative institution building, or health care reform.

Health Care Politics And Policy In America

Author: Kant Patel
Publisher: M.E. Sharpe
ISBN: 9780765628473
Size: 67.17 MB
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Fully updated for this new edition, Health Care Politics and Policy in America combines background and context for the evolution of U.S. health care policy with analysis of recent trends and current issues. The book introduces public policy students to the complex array of health care issues, and health care professionals to the study of public policy. It provides comprehensive coverage of policy issues related to health care at the federal, state, and provider/patient levels, from Medicare and Medicaid funding and managed care to medical liability law and ongoing debates over the beginning of life and end-of-life decisions. Health Care Politics and Policy in America successfully integrates political, ethical, economic, legal, technological, and medical factors in an issue-focused survey of U.S. health care policy. It includes a chronology of health care-policy-related events and legislation from 1798 through 2005, and an appendix comparing medical malpractice tort laws state-by-state.

The Public Private Health Care State

Author: Rosemary A. Stevens
Publisher: Transaction Publishers
ISBN: 9781412809689
Size: 52.12 MB
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The distinctive mixing and continuous remixing of public and private roles is a defining feature of health care in the United States. The Public-Private Health Care State explores the interweaving of public and private enterprise in health care in the United States as a basis for thinking about health care in terms of its history and its continuing evolution today. Historian and policy analyst Rosemary Stevens has selected and edited seventeen essays from both her published and unpublished work to illustrate continuing themes, such as: the flexible meanings of the terms "public" and "private," and how useful their ambiguity has been and is; the role of ideology as ratifying rather than preordaining change; and the common behavior of public leaders and corporate entities in the face of fiscal opportunity. The topics--covering the period of 1870 through the twenty-first century--represent Stevens' research interests in hospital history and policy, the medical profession, government policy, and paying for health care. The volume also considers her involvement with policy questions, which include health services research, health maintenance organizations, and physician workforce policy. Section I demonstrates the long history of state government involvement with private not-for-profit hospitals from the 1870s through the 1930s. Section II examines the federal role in health care from the 1920s through the 1970s, including the establishment of veterans' hospitals and the implementation of Medicaid. Section III shows how shifting governmental roles require constantly changing organizing rhetoric, whether for inventing a federal role for health services research and HMOs, "regionalization" in the 1970s, or defining civil rights and "equity" as mobilizing vehicles in the 1980s. Section IV examines growing concerns from the 1970s through the present about the traditional "public" role of the largely "private" medical profession. Section V returns to the ambiguous public-private status of not-for profit hospitals, buffeted in the 1980s and 1990s by assumptions about the efficiency of the market.