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David F. Drake - Reforming the health care market: an interpretive economic history

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Examining the health care market in a historical framework, Drake analyzes the forces and events that have shaped American health care in the twentieth century and sheds new light on why and how our health care system has dampened competitive market forces and failed to provide sound value for much of our health care expenditures. He examines the roles that physicians, hospitals, insurance companies, businesses, individual consumers, and government legislation have played in creating a provider-dominated market in which the cost of care has been concealed from consumers. Comparing U.S. health care expenditures with those of other developed countries, he concludes that a significant part of our health care problem is the style of medicine practiced in the United States, which is much more specialized and high tech than in other developed nations. Drake develops proposals for health care financing reform that consider the political and economic difficulties involved. He first examines the Clinton health care reform plan and makes specific recommendations for revisions that would improve its likelihood of controlling costs. He then offers an alternative proposal that would both maintain the principle of universal, noncancelable coverage and eliminate the flaws in the market for health care services by giving consumers a financial stake in cost containment. This timely argument, combining economic and historical analysis with thoughtful consideration of the motivating humanitarian and political concerns, will be of interest to everyone seeking to understand and to reform our ailing health care system.

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title Reforming the Health Care Market An Interpretive Economic History - photo 1

title:Reforming the Health Care Market : An Interpretive Economic History
author:Drake, David F.
publisher:Georgetown University Press
isbn10 | asin:0878405682
print isbn13:9780878405688
ebook isbn13:9780585214283
language:English
subjectMedical economics--United States--History--20th century, Health care reform--United States.
publication date:1994
lcc:RA410.53.D73 1994eb
ddc:362.1/0973
subject:Medical economics--United States--History--20th century, Health care reform--United States.
Page iii
Reforming the Health Care Market
An Interpretive Economic History
David F. Drake
GEORGETOWN UNIVERSITY PRESS/WASHINGTON, D.C.
Page iv
Georgetown University Press, Washington, D.C.
1994 by Georgetown University Press. All rights reserved.
Printed in the United States of America
10 9 8 7 6 5 4 3 2 1 1994
THIS VOLUME IS PRINTED ON ACID-FREE OFFSET BOOK PAPER
Library of Congress Cataloging-in-Publication Data
Drake, David F.
Reforming the health care market: an interpretive economic
history / David F. Drake.
p. cm.
1. Medical economicsUnited StatesHistory20th century.
2. Health care reformUnited States. I. Title.
RA410.53.D73 1994
362.1'0973dc20
ISBN 0-87840-567-4. ISBN 0-87840-568-2 (pbk.) 94-13475
Page v
To Cy and Alex
with great appreciation
Page vii
Contents
List of Tables
ix
Preface
xi
1
History, Reform, and the Health Care Market
1
Picture 2
Health Care Reform Proposals
2
Picture 3
The Current State of the Health Care Market
5
Picture 4
The Study
20
2
Establishing a Market for Health Care Services, 19001940
23
Picture 5
Creating the Institutional Health Care Market 19001929
23
Picture 6
Developing Financing and Marketing Mechanisms 19301940
42
Picture 7
Poised for Growth
53
3
The Imprinting of Scientific Medicine on America, 19411965
54
Picture 8
Perfect Timing for Growth
55
Picture 9
Stifling Health Care Competition
61
Picture 10
Establishing the Launching Pad for Explosive Growth: A Summary of the First Growth Phase
77
4
The Exploding Market for Health Services, 19661979
80
Picture 11
Expansion of Health Care Demand
81
Picture 12
Searching for the Brakes
87
Picture 13
The Rise of the Physician Entrepreneur
99
Picture 14
An Industry Under Siege
103

Page viii
5
Provider Competition in an Era of Continuing Growth, 1980 to the Present
104
Picture 15
Shifting Balance of Health Care Providers
106
Picture 16
The Resurgence of Health Insurers
114
Picture 17
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