This ground-breaking book investigates the work of policy professionals. They consist of political actors who, although not elected to office, are nonetheless employed to affect policy and politics on a partisan basis. Through an analysis of the influence and power they wield, this book sheds light on how the growth of this group represents a major transformation of the organization of politics and policy-making in advanced democracies.

This book is a history of political consulting in America, examining how the consulting business developed, highlighting the major figures in the consulting industry and assessing the impact of professional consulting on elections and American democracy. A key focus is on presidential elections, beginning in 1964, and the important role played by consultants and political operatives.

Reveals the formidable organization of intelligence outsourcing that has developed between the U.S. government and private companies since 9/11, in a report that reveals how approximately seventy percent of the nation's funding for top-secret tasks is now being funneled to higher-cost third-party contractors. 35,000 first printing.

In recent years, government's primary response to the emergent problems of homelessness, hunger, child abuse, health care, and AIDS has been generated through nonprofit agencies funded by taxpayer money. As part of the widespread movement for privatization, these agencies represent revolutionary changes in the welfare state. Steven Smith and Michael Lipsky demonstrate that this massive shift in funds has benefits and drawbacks. Given the breadth of government funding of nonprofit agencies, this first study of the social, political, and organizational effects of this service strategy is an essential contribution to the current raging debates on the future of the welfare state. Reviews of this book: "An insightful analysis of the implications of an important, broad trend of the past thirty years in the social welfare policy of the United States and many other countries...[Smith and Lipsky] demonstrate that we do not have to read about other countries to find a comparative perspective that sheds light on the choices we face in our national health care debate." DD--Bradford H. Gray, Health Affairs "The most comprehensive account we have of the history, extent, nature, and meaning of delivering social services that are paid for by government and delivered through nonprofit organizations." DD--H. Brinton Milward, Public Administration Review "An interesting, absorbing, and important book." DD--William T. Gormley, Jr., American Political Science Review "An important contribution to welfare state scholarship." DD--Kirsten A. Gronbjerg, Contemporary Sociology

Today, more than 75 percent of pharmaceutical drug trials in the United States are being conducted in the private sector. Once the sole province of academic researchers, these important studies are now being outsourced to non-academic physicians. According to Jill A. Fisher, this major change in the way medical research is performed is the outcome of two problems in U.S. health care: decreasing revenue for physicians and decreasing access to treatment for patients. As physicians report diminishing income due to restrictive relationships with insurers, increasing malpractice insurance premiums, and inflated overhead costs to operate private practices, they are attracted to pharmaceutical contract research for its lucrative return. Clinical trials also provide limited medical access to individuals who have no or inadequate health insurance because they offer "free" doctors' visits, diagnostic tests, and medications to participants. Focusing on the professional roles of those involved, as well as key research practices, Fisher assesses the risks and advantages for physicians and patients alike when pharmaceutical drug studies are used as an alternative to standard medical care. A volume in the Critical Issues in Health and Medicine series, edited by Rima D. Apple and Janet Golden

This book examines how elite consultants are reshaping democracy by helping corporations and powerful advocacy groups to mobilize grassroots participation.