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"Drawing upon a wealth of research, Coombs compares HMOs throughout the nation with the one in Marshfield, which came as close as any HMO to realizing the ideal of early advocates. This book is a resource for specialists in the fields of health policy research and analysis, health care management, health law and politics, public health, and social and organizational history of medicine. It will also appeal to many readers who are disturbed by the current stae of America's health care system and are curious about its future."--BOOK JACKET.
A detailed history of the managed health care movement as recorded by Dr. Smith provides insight into the current turmoil in the medical profession. Relating physician behavior to the social psychology of mass movement gives us an understanding of the initial acceptance of the negative effects of managed care.
Casting recent changes in health care as the product of a mass movement, and comparing this movement to others like it, this brief history recounts the sudden rise and long decline of managed care. Chapters discuss its origins, expansion, supporters, financiers, the resistance it faced, the bind it created, early tremors, its collapse, and its current state. Smith's credentials are not noted. Annotation copyrighted by Book News, Inc., Portland, OR.
Among various health cost containment strategies proposed during the 1970s, none has held more sustained fascination than the health maintenance organization (HMO). For many years, policy analysts in search of market- and incentive-based alternatives to “command and control” regulation have argued that medical groups combining prepayment and group practice, and offering comprehensive medical services within a fixed budget, would hold down costs both by their own efficient operations and by the competitive pressures they would apply to the conventional systems. During the 1970s, three presidents and five Congresses worked to formulate and implement legislation to increase the HMO presence nationwide, with very modest results. Some observers concluded that but for the well-intended but counterproductive efforts of the federal government, HMOs might thrive. Indeed, the Reagan administration has called for an end to direct federal financial involvement in building HMOs—though it has also promised legislation to promote HMOs and a newly competitive health care system based on revamped financial incentives and reinvigorated markets. In this book, Lawrence D. Brown, a senior fellow in the Brookings Governmental Studies program, examines the interplay between politics and policy in the federal HMO development effort between 1970 and 1980. He argues that the basic explanation for the disappointments of the policy analysts and federal supporters of HMOs lies not in a political miscarriage but in the overambitious promises of the policy strategy itself. Tracing the poor fit between policy and politics revealed by federal efforts to translate the attractive HMO idea into a workable strategy, Brown concludes that the episode augurs poorly for the competitive reforms frequently offered as a nonregulatory solution to rising health care costs in the 1980s.
The purpose of this research is to determine factors associated with differential HMO enrollment growth across metropolitan statistical areas (MSAs). The study examines 2 periods, 1973-1978 and 1988-1993, during which national HMO enrollment grew substantially. Results for the 2 periods are compared to determine the stability of statistical relationships. Data was collected for the 75 largest U.S. MSAs as of 1990.
Called "a must-read" by the AMA, this book reveals the problems within the HMO system that could cost people their lives. A "chilling portrait of the many ways in which HMOs can be hazardous to your health", says the "Cleveland Plain Dealer".
How America's high standard of living came to be and why future growth is under threat In the century after the Civil War, an economic revolution improved the American standard of living in ways previously unimaginable. Electric lighting, indoor plumbing, motor vehicles, air travel, and television transformed households and workplaces. But has that era of unprecedented growth come to an end? Weaving together a vivid narrative, historical anecdotes, and economic analysis, The Rise and Fall of American Growth challenges the view that economic growth will continue unabated, and demonstrates that the life-altering scale of innovations between 1870 and 1970 cannot be repeated. Gordon contends that the nation's productivity growth will be further held back by the headwinds of rising inequality, stagnating education, an aging population, and the rising debt of college students and the federal government, and that we must find new solutions. A critical voice in the most pressing debates of our time, The Rise and Fall of American Growth is at once a tribute to a century of radical change and a harbinger of tougher times to come.
Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
Managed Care
The new edition of a widely used introduction to game theory and its applications, with a focus on economics, business, and politics. This widely used introduction to game theory is rigorous but accessible, unique in its balance between the theoretical and the practical, with examples and applications following almost every theory-driven chapter. In recent years, game theory has become an important methodological tool for all fields of social sciences, biology and computer science. This second edition of Strategies and Games not only takes into account new game theoretical concepts and applications such as bargaining and matching, it also provides an array of chapters on game theory applied to the political arena. New examples, case studies, and applications relevant to a wide range of behavioral disciplines are now included. The authors map out alternate pathways through the book for instructors in economics, business, and political science. The book contains four parts: strategic form games, extensive form games, asymmetric information games, and cooperative games and matching. Theoretical topics include dominance solutions, Nash equilibrium, Condorcet paradox, backward induction, subgame perfection, repeated and dynamic games, Bayes-Nash equilibrium, mechanism design, auction theory, signaling, the Shapley value, and stable matchings. Applications and case studies include OPEC, voting, poison pills, Treasury auctions, trade agreements, pork-barrel spending, climate change, bargaining and audience costs, markets for lemons, and school choice. Each chapter includes concept checks and tallies end-of-chapter problems. An appendix offers a thorough discussion of single-agent decision theory, which underpins game theory.