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Author Mulligan, Jessica M
Title Unmanageable care : an ethnography of health care privatization in Puerto Rico / Jessica M. Mulligan
Imprint New York : New York University Press, [2014]
book jacket
 人文社會聯圖  RA395.P7 M85 2014    AVAILABLE    30610020447355
Descript xii, 299 pages : illustrations ; 24 cm
text rdacontent
unmediated rdamedia
volume rdacarrier
Note "In Unmanageable Care, anthropologist Jessica M. Mulligan goes to work at an HMO and records what it's really like to manage care. Set at a health insurance company dubbed Acme, this book chronicles how the privatization of the health care system in Puerto Rico transformed the experience of accessing and providing care on the island. Through interviews and participant observation, the book explores the everyday contexts in which market reforms were enacted. It follows privatization into the compliance department of a managed care organization, through the visits of federal auditors to a health plan, and into the homes of health plan members who recount their experiences navigating the new managed care system.In the 1990s and early 2000s, policymakers in Puerto Rico sold off most of the island's public health facilities and enrolled the poor, elderly and disabled into for-profit managed care plans. These reforms were supposed to promote efficiency, cost-effectiveness, and high quality care. Despite the optimistic promises of market-based reforms, the system became more expensive, not more efficient; patients rarely behaved as the expected health-maximizing information processing consumers; and care became more chaotic and difficult to access. Citizens continued to look to the state to provide health services for the poor, disabled, and elderly. This book argues that pro-market reforms failed to deliver on many of their promises.The health care system in Puerto Rico was dramatically transformed, just not according to plan"-- Provided by publisher
Includes bibliographical references (pages 277-294) and index
Subject Medical care -- Puerto Rico
Medical policy -- Puerto Rico
Health care reform -- Puerto Rico
Privatization -- Puerto Rico
SOCIAL SCIENCE / Anthropology / Cultural. bisacsh
SOCIAL SCIENCE / Sociology / General. bisacsh
BUSINESS & ECONOMICS / Insurance / Health. bisacsh
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