The medical delivery business : health reform, childbirth, and the economic order / Barbara Bridgman Perkins.

Format:

Book

Author/Creator:

Perkins, Barbara Bridgman.

Language:

English

Subjects (All):

Health services administration--Economic aspects--United States.

Health services administration.

Health planning--Economic aspects--United States.

Health planning.

Medical economics--United States.

Medical economics.

Medical policy--United States--History.

Medical policy.

Health care reform--United States--History.

Health care reform.

Maternal health services--Economic aspects--United States.

Maternal health services.

Physical Description:

1 online resource (267 p.)

Edition:

1st ed.

Place of Publication:

New Brunswick, N.J. : Rutgers University Press, c2004.

Language Note:

English

Summary:

Americans at the end of the twentieth century worried that managed care had fundamentally transformed the character of medicine. In The Medical Delivery Business, Barbara Bridgman Perkins uses examples drawn from maternal and infant care to argue that the business approach in medicine is not a new development. Health care reformers throughout the century looked to industrial, corporate, and commercial enterprises as models for the institutions, specialties, and technological strategies that defined modern medicine. In the case of perinatal care, the business model emphasized specialized over primary care, encouraged the use of surgical and technological procedures, and unnecessarily turned childbirth into an intensive care situation. Active management techniques, for example, encouraged obstetricians to accelerate labor with oxytocin to augment their productivity. Despite the achievements of the childbirth and women's health movement in the 1970s, aggressive medical intervention has remained the birth experience for millions of American women (and their babies) every year. The Medical Delivery Business challenges the conventional view that a dose of the market is good for medicine. While Perkins is sympathetic to the goals of progressive and feminist reformers, she questions whether their strategies will succeed in making medicine more equitable and effective. She argues that the medical care system itself needs to be fundamentally "re-formed," and the reforms must be based on democracy, caring, and social justice as well as economics.

Contents:

Business models and medical interventions

Medical specialism and early-twentieth-century economic organization

Academic specialty departments and scientific management

Dividing labor, industrializing birth

Designing delivery systems

The Committee on the Costs of Medical Care and corporate organization of medicine

Regional health planning and the economic organization of the medical industry

Perinatal regionalization and economic order

The economic production of childbirth

Competing for the birth market: providers, procedures, and paradigms

Capital intensive medicine and academic practice plans

Managing birth: managed care and active management of labor

Re-forming medicine, reforming reform.

Notes:

Bibliographic Level Mode of Issuance: Monograph

Includes bibliographical references (p. 169-238) and index.

ISBN:

0-8135-5947-2

0-8135-3636-7

OCLC:

56823174