Markets, not politics, are driving health care reform in America today. Inventive entrepreneurs have transformed medicine over the past ten years, and no end to this period of rapid change is in sight. Consumer anxieties over managed care are mounting, and medical costs are again soaring. Meanwhile, the federal government remains mostly on the health policy sidelines, as it has since the collapse of the Clinton administration's campaign for health care reform. This book addresses the changes that the market has wrought- and the challenges this transformation poses for courts and regulators. The law that governs the medical marketplace is an incomplete, overlapping patchwork, conceived mainly without medical care specifically in mind. The ensuing confusion and incoherence are a central theme of this book. Fragmentation of health care lawmaking has foreclosed coordinated, system-wide policy responses, and lack of national consensus on many of the central questions in health care policy has translated into legal contradiction and bitter controversy. Written by leading commentators on American health law and policy, this book examines the widely-perceived failings of managed care and the law's relationship to them. Some of the contributors treat law as a cause of trouble; others emphasize the law's potential and limits as a corrective tool when the market disappoints. The first two chapters present contrasting overviews of how the doctrines and decision-makers that constitute health law work together, for better or worse, to constrain the medical marketplace. The next six chapters address particular market developments and regulatory dilemmas. These include the power of state versus federal government in the health sphere, conflict between insureres and patients and providers over medical need, financial rewards to physicians for frugal practice, the role of antitrust law in the organization of health care provision and financing, the future of public hospitals, and the place of investor-owned versus non-profit institutions. Acknowledging the health sphere's complexities, the authors seek remedies that fit this country's legal, political, and cultural constraints and can contribute to reasoned regulatory goverance. Within limits they believe a measure of rationality is possible.

A remarkable transformation in American health-care delivery and financing is taking place, led by the private sector. This transformation presents myriad new legal and regulatory questions that have received little scholarly attention. These issues receive balanced, critical coverage in this book, which is intended for health-care policymakers, hospital and managed care executives, lawyers, clinical practitioners, students of law, medicine and public health, and academic departments of economics, political science and sociology.

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

The reform of American medical care is the most important topic on the nation's domestic agenda and the centerpiece of the Clinton administration's plans for social policy and long-term economic development. This book, written by a preeminent analyst of medical politics and policy who is a frequent adviser to Congress, helps to clarify the current debate over the President's bill and the proposed alternatives to it. It is essential reading. Theodore Marmor, whose work has appeared in the nation's major newspapers and magazines, as well as in scholarly journals and books, here presents some of his most recent writings that illuminate the historical, political, and economic considerations behind various proposals now under debate. Marmor explains what we can and cannot expect from reform of American medicine, and he addresses the many conflicting claims about remedies for America's problems with medical costs, quality of care, and access to treatment.

This compilation is a valuable tool for policymakers and all others concerned with the most pressing social issue of our time. Editor Pauline Vaillancourt Rosenau has brought together a diverse group of distinguished scholars and policymakers to examine health reform issues, offering readers the broadest possible perspective.

The United States spends more money on health care by far than any other country and yet nearly 50,000,000 Americans are uninsured at least part of the time each year. Health Care Reform Now! is written for anyone who cares enough about our health care situation to consider serious alternatives to the current system. In this book George Halvorson—an internationally known health care leader and author—offers a sensible approach to health care reform and universal coverage that can work for all stakeholders. Step by step, George Halvorson outlines a game plan for a truly world-class health care system that will appeal to policy makers on both ends of the political spectrum and will deliver health care with improved quality, better access, provider accountability, performance transparency, consumer choice, and individual empowerment. As readable as it is instructive, Health Care Reform Now! proposes a practical model that solves the unsolvable by identifying specific areas where health care performance can create better outcomes, better choices, and far better use of the health care dollar. Halvorson explains why "reform" itself needs to be a "product" rather than just a concept. He also explains why quick action is essential and how using the right tools—the focus on real costs and the use of real data and better caregiver support systems—can make universal coverage easy to administer, efficient, affordable, and "free" in three years—compared to what the total cost of care would be without universal coverage.