by T R Marmor (Yale University, USA)

Table of Contents (59k)
Preface (66k)
Chapter 1: Fads in Medical Care Policy andPolitics: The Rhetoric and Realityof Managerialism (462k)

Ted Marmor began his public career as a special assistant to Wilbur Cohen (Secretary of HEW) in the mid-1960s. He was associate dean of Minnesota's School of Public Affairs, a faculty member at the University of Chicago, the head of Yale's Center for Health Services, a member of President Carter's Commission on the National Agenda in the 1980s, and a senior social policy advisor to Walter Mondale in the Presidential campaign of 1984. He has testified before Congress about medical care reform, social security, and welfare issues, as well as being a consultant to government and non-profit agencies such as the US Department of Health and Human Services, Congressional Committee on Ways and Means, President's Commission on Income Maintenance, National Institute for Mental Health, and The Ford Foundation. Marmor's scholarship primarily concerns the politics of welfare state policy disputes in North America and Western Europe. He has particularly emphasized the major spending programs, which is reflected in the second edition of The Politics of Medicare (Aldine de Gruyter, 2000) and written a book with colleagues Mashaw and Harvey in the early l990s, America's Misunderstood Welfare State (Basic Books, l992). As author or co-author of eleven books, Marmor has also published over a hundred articles in a wide range of scholarly journals, as well as being a frequent op-ed contributor to US and Canadian newspapers. Marmor lectures frequently on health policy, management issues, and law to both management and law students. He has been an expert witness in cases ranging from the constitutionality of the Canada Health Act to mass tort asbestos. He has also been a commentator on a variety of television and radio programs.
 

No one misses the onslaught of claims about reforming modern medical care. How doctors should be paid, how hospitals should be paid or governed, how much patients should pay when sick in co-payments, how the quality of care could be improved, and how governments and other buyers could better control the costs of care — all find expression in the explosion of medical care conference proceedings, op-eds, news bulletins, journal articles, and books.

This collection of articles takes up a key set of what the author regards as particularly misleading fads and fashions — developments that produce a startling degree of foolishness in contemporary discussions of how to organize, deliver, finance, pay for and regulate medical care services in modern industrial democracies.

The policy fads addressed include the celebration of explicit rationing as a major cost control instrument, the belief in a “basic package” of health insurance benefits to constrain costs, the faith that contemporary cross-national research can deliver a large number of transferable models, and the notion that broadening the definition of what is meant by health will constitute some sort of useful advance in practice.

• Fads in Medical Care Policy and Politics: The Rhetoric and Reality of Managerialism
• How Not to Think About “Managed Care”
• Medical Care and Public Policy: The Benefits and Burdens of Asking Fundamental Questions
• Medicare and Political Analysis: Omissions, Understandings, and Misunderstandings
• Comparative Perspectives and Policy Learning in the World of Health Care
• How Not to Think About Medicare Reform