The rise and fall of HMOs : an American health care revolution / Jan Gregoire Coombs.

Format:

Book

Author/Creator:

Coombs, Jan.

Contributor:

Edward Potts Cheyney Memorial Fund.

Language:

English

Subjects (All):

Health maintenance organizations--United States--History.

Health maintenance organizations.

Health maintenance organizations--Wisconsin--History.

Health care reform--United States--History.

Health care reform.

Marshfield Clinic.

Health Maintenance Organizations--history.

History.

United States.

Wisconsin.

Health Care Reform--history.

Organizational Case Studies.

Medical Subjects:

Health Maintenance Organizations--history.

United States.

Wisconsin.

Health Care Reform--history.

Organizational Case Studies.

Physical Description:

xviii, 412 pages ; 24 cm

Place of Publication:

Madison, Wis. : University of Wisconsin Press, [2005]

Summary:

The United States government began to promote Health Maintenance Organizations in the early 1970s, shortly after Medicare and Medicaid gave millions of elderly and poor Americans access to health care which caused acute shortages of medical personnel and resources and unprecedented health care costs.

In this timely book, Jan Gregoire Coombs tells why HMOs failed to improve services or control costs. Using Wisconsin's Marshfield Clinic as a case study, Coombs examines the advantages and disadvantages of publicly and privately financed medical care, and of nonprofit and for-profit systems; the implications of benefits coverage and pharmaceutical costs on employers, employees and patients; and issues involving medical ethics and autonomy, clinical practice guidelines, managed care strategies, rationing, and patients' rights.

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 vital 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 state of America's health care system and are curious about its future.

Contents:

American health care insurance prior to 1970

Dreams of a medical utopia

The HMO Act and its aftermath

Health care in rural America

Affiliated providers and necessary compromises

Emerging problems with Medicare and Medicaid

Entering a management revolution

Assessing HMO quality and consumer satisfaction in the 1980s

Idealism confronts realities

Competing values doom a partnership

The perils of antitrust in the health care marketplace

HMOs and public programs in the 1990s

HMO enrollment growth in the private sector in the 1990s and early 2000s

Demands for accountability

Critics and would-be reformers

Conclusion: lessons from Marshfield.

Notes:

Includes bibliographical references (pages 305-398) and index.

Local Notes:

Acquired for the Penn Libraries with assistance from the Edward Potts Cheyney Memorial Fund.

ISBN:

0299202402

OCLC:

55587158

Publisher Number:

9780299202408

Online:

Contributor biographical information