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The Revolt of the Corporate Purchaser

Jill Quadagno

in One Nation, Uninsured: Why the U.S. Has No National Health Insurance

Published in print:
2006
Published Online:
May 2012
ISBN:
9780195160390
eISBN:
9780199944026
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195160390.003.0007
Subject:
Sociology, Race and Ethnicity

This chapter shows how the failure of federal cost containment provoked corporate purchasers to experiment with their own methods for controlling costs, leading to managed care in the 1990s and ... More


Human Service Organizations: Dead or Alive?

Sandra L. Bloom and Brian Farragher

in Destroying Sanctuary: The Crisis in Human Service Delivery Systems

Published in print:
2010
Published Online:
January 2011
ISBN:
9780195374803
eISBN:
9780199865420
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195374803.003.0002
Subject:
Social Work, Health and Mental Health

Mental models are the largely unconscious ideas and beliefs that structure what we think about–and what we do not consider. Mental models represent mental short-cuts and limitations. This chapter ... More


Medical Education in an Era of Cost Containment and Managed Care

Kenneth M. Ludmerer

in Time to Heal: American medical education from the turn of the century to the era of managed care

Published in print:
2005
Published Online:
October 2011
ISBN:
9780195181364
eISBN:
9780199850167
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195181364.003.0017
Subject:
History, American History: 20th Century

In the mid-1980s a new paradigm became accepted, which emphasized that there were limits to what the country could spend on health care, given the reality of finite resources in the face of a ... More


How the Government Created Private Health Insurance

Robert I. Field

in Mother of Invention: How the Government Created "Free-Market" Health Care

Published in print:
2013
Published Online:
January 2014
ISBN:
9780199746750
eISBN:
9780199354528
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780199746750.003.0006
Subject:
Public Health and Epidemiology, Public Health

Private health insurance emerged from the efforts of hospitals and physicians to devise alternative payment arrangements during the Great Depression. Two federal policiesfostered its spread during ... More


Coping with Physicians’ Conflicts of Interest in the United States

Marc A. Rodwin

in Conflicts of Interest and the Future of Medicine: The United States, France, and Japan

Published in print:
2011
Published Online:
May 2011
ISBN:
9780199755486
eISBN:
9780199894918
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780199755486.003.0008
Subject:
Political Science, Comparative Politics

This chapter begins with a discussion of the three approaches used by the United States to cope with physicians' conflicts of interest that interact: professional and industry self-regulation, ... More


“We Were the Invisible Workforce”

Eileen Boris and Jennifer Klein

in Caring for America: Home Health Workers in the Shadow of the Welfare State

Published in print:
2012
Published Online:
May 2012
ISBN:
9780195329117
eISBN:
9780199949496
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195329117.003.0007
Subject:
Political Science, American Politics

This chapter discusses SEIU’s massive Los Angeles victory in 1999 in light of the Americans with Disability Act, welfare reform, Clinton’s health care debacle, and managed care. In California, the ... More


Regulation and Administration of Health Care Finance

Robert I. Field

in Health Care Regulation in America: Complexity, Confrontation, and Compromise

Published in print:
2006
Published Online:
September 2009
ISBN:
9780195159684
eISBN:
9780199864423
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195159684.003.0004
Subject:
Public Health and Epidemiology, Public Health, Epidemiology

This chapter considers the financing of health care. It explains the history of private health insurance, including favorable tax and regulatory provisions that have sustained it over the years, and ... More


The Changing Relationship between Health Plans and Their Members

Charles M. Cutler

in The Trust Crisis in Healthcare: Causes, Consequences, and Cures

Published in print:
2006
Published Online:
September 2009
ISBN:
9780195176360
eISBN:
9780199865598
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195176360.003.16
Subject:
Public Health and Epidemiology, Public Health, Epidemiology

Managed care organizations (MCOs) provide a unique service by monitoring and assessing areas for improvement in healthcare. A brief historical account of the development of health insurance in the ... More


Time to Heal: American medical education from the turn of the century to the era of managed care

Kenneth M. Ludmerer

Published in print:
2005
Published Online:
October 2011
ISBN:
9780195181364
eISBN:
9780199850167
Item type:
book
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195181364.001.0001
Subject:
History, American History: 20th Century

This book provides an account of American medical education in the 20th century, concluding with a call for the reformation of a system currently handicapped by managed care and by narrow, ... More


The Scientific Management of Life—and Death: Part II

Simon Head

in The New Ruthless Economy: Work and Power in the Digital Age

Published in print:
2005
Published Online:
October 2011
ISBN:
9780195179835
eISBN:
9780199850211
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195179835.003.0008
Subject:
Economics and Finance, Behavioural Economics

This chapter examines managerial medicine's effort to standardize industrial engineering in hospitals, clinic and the doctor's office. Managerial medicine provides a long agenda for investigation. ... More


Structuring Treatment: From Managed Care to Treatment Manuals

Larry E. Beutler, John F. Clarkin, and Bruce Bongar

in Guidelines for the Systematic Treatment of the Depressed Patient

Published in print:
2000
Published Online:
March 2012
ISBN:
9780195105308
eISBN:
9780199848522
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195105308.003.0012
Subject:
Psychology, Clinical Psychology

Evidence is now emerging that certain characteristics, either hidden within or masked by diagnostic criteria, may predetermine a patient's ... More


Accountability for Reasonableness in Action: Public Sector Mental Health Contracting

Norman Daniels and James E. Sabin

in Setting Limits Fairly: Can we learn to share medical resources?

Published in print:
2002
Published Online:
September 2009
ISBN:
9780195149364
eISBN:
9780199865123
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195149364.003.0009
Subject:
Public Health and Epidemiology, Public Health, Epidemiology

This chapter looks at how public contracting for mental health care delivered by private, for-profit, managed care organizations can contain measures to ensure such accountability. Specifically, it ... More


The Distinctiveness of the Psychiatric Setting

Jennifer Radden and John Z. Sadler

in The Virtuous Psychiatrist: Character Ethics in Psychiatric Practice

Published in print:
2009
Published Online:
February 2010
ISBN:
9780195389371
eISBN:
9780199866328
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195389371.003.0003
Subject:
Philosophy, Moral Philosophy, General

Chapter 2 puts forward a systematic and developed rationale for the view introduced previously that psychiatry requires its own ethics. Few aspects of psychiatric practice are medically unique, yet ... More


Introduction: Learning to Manage

Jessica M. Mulligan

in Unmanageable Care: An Ethnography of Health Care Privatization in Puerto Rico

Published in print:
2014
Published Online:
March 2016
ISBN:
9780814724910
eISBN:
9780814764992
Item type:
chapter
Publisher:
NYU Press
DOI:
10.18574/nyu/9780814724910.003.0001
Subject:
Anthropology, Medical Anthropology

This introductory chapter explores the changes made to the national health care system of Puerto Rico as a result of the passing of the Medicare Modernization Act (MMA) in 2003—a legislation that ... More


The Impacts of Managed Care

Eli Ginzberg

in Teaching Hospitals and the Urban Poor

Published in print:
2000
Published Online:
October 2013
ISBN:
9780300082326
eISBN:
9780300133011
Item type:
chapter
Publisher:
Yale University Press
DOI:
10.12987/yale/9780300082326.003.0006
Subject:
Sociology, Social Stratification, Inequality, and Mobility

This chapter examines the rise and growth of managed care plans and their impact on the academic health centers (AHCs) and the urban poor. It begins by exploring the rise of the independent ... More


Has the Magic of Psychotherapy Disappeared? Integrating Evidence-Based Practice into Therapist Awareness and Development

Debra Theobald McClendon and Gary M. Burlingame

in On Becoming a Psychotherapist: The Personal and Professional Journey

Published in print:
2010
Published Online:
May 2011
ISBN:
9780199736393
eISBN:
9780199894574
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780199736393.003.0009
Subject:
Psychology, Clinical Psychology

The tension between creative, interconnected aspects of psychotherapy (magic) and measurement requirements are examined in relation to its affect on therapist awareness and development. This ... More


Regulation of Physicians and Other Health Care Professionals

Robert I. Field

in Health Care Regulation in America: Complexity, Confrontation, and Compromise

Published in print:
2006
Published Online:
September 2009
ISBN:
9780195159684
eISBN:
9780199864423
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195159684.003.0002
Subject:
Public Health and Epidemiology, Public Health, Epidemiology

This chapter presents the regulatory structure for health care professionals with an emphasis on physicians. It traces the history of the formalization of the medical profession, initiated by the ... More


Conclusion: Ungovernability as Market Rule

Jessica M. Mulligan

in Unmanageable Care: An Ethnography of Health Care Privatization in Puerto Rico

Published in print:
2014
Published Online:
March 2016
ISBN:
9780814724910
eISBN:
9780814764992
Item type:
chapter
Publisher:
NYU Press
DOI:
10.18574/nyu/9780814724910.003.0008
Subject:
Anthropology, Medical Anthropology

This concluding chapter argues that the privatization of the Medicare and Medicaid programs in Puerto Rico failed despite promising more efficient care management and expanded access to ... More


Fraud in Fee-for-Service and Managed Care: Different Sides of the Same Coin

Terry L. Leap

in Phantom Billing, Fake Prescriptions, and the High Cost of Medicine: Health Care Fraud and What to Do about It

Published in print:
2011
Published Online:
August 2016
ISBN:
9780801449796
eISBN:
9780801460807
Item type:
chapter
Publisher:
Cornell University Press
DOI:
10.7591/cornell/9780801449796.003.0003
Subject:
Sociology, Health, Illness, and Medicine

This chapter examines fraud in fee-for-service systems and managed care plans. A common health care fraud that is linked directly to fee-for-service is the submission of fraudulent claims to the ... More


Lessons from Oregon

Peter J. Neumann

in Using Cost-Effectiveness Analysis to Improve Health Care: Opportunities and barriers

Published in print:
2004
Published Online:
September 2009
ISBN:
9780195171860
eISBN:
9780199865345
Item type:
chapter
Publisher:
Oxford University Press
DOI:
10.1093/acprof:oso/9780195171860.003.0006
Subject:
Public Health and Epidemiology, Public Health, Epidemiology

This chapter describes Oregon's experiment with cost-effectiveness as part of a grander proposal to overhaul the state's health insurance system. It discusses the plan itself, the debate surrounding ... More


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