But first, medical records must be made more complete and accessible a task that need not compromise patient confidentiality, MCOs must improve their ways of measuring provider performance, and patients must be willing to seek and act on information about the best care available. The book covers everything from start-up troubles with the first managed care organizations to attempts at government regulation to the mergers and quality control issues facing MCOs today.

Many observers accuse MCOs of caring more about cost than quality, and argue for government regulation. The american health care industry has undergone such dizzying transformations since the 1960s that many patients have lost confidence in a system they find too impersonal and ineffectual. Up until the 1970s, patients looked to autonomous physicians for recommendations on procedures and hospitals--a process that relied more on the patient's trust of the physician than on facts, and resulted in skyrocketing medical costs.

Newly emerging mcos have tried to solve the shopping problem by tracking the performance of care providers while obtaining discounts for their clients. Focusing on the doctor-patient relationship, he begins with the era of the independently practicing physician--epitomized by Marcus Welby, the beloved father figure/doctor in the 1960s television show of the same name--who disappeared with the growth of managed care.

It also reflects on how difficult it is for patients to shop for medical care. Is their distrust justified and can confidence be restored? David Dranove, a leading health care economist, tackles these and other key questions in the first major economic and historical investigation of the field. Dranove, however, believes that market forces can eventually achieve quality care and cost control.

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The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry

Basic. Considered the definitive history of the american healthcare system, The Social Transformation of American Medicine examines how the roles of doctors, hospitals, health plans, and government programs have evolved over the last two and a half centuries. How did the financially insecure medical profession of the nineteenth century become a most prosperous one in the twentieth century? Why was national health insurance blocked? And why are corporate institutions taking over our medical care system today? Beginning in 1760 and coming up to the present day, the political struggles over healthcare, renowned sociologist Paul Starr traces the decline of professional sovereignty in medicine, and the rise of a corporate system.

Updated with a new preface and an epilogue analyzing developments since the early 1980s, this new edition of The Social Transformation of American Medicine is a must-read for anyone concerned about the future of our fraught healthcare system.