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The Fragmentation of U.S. Health CareCauses and Solutions$
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Einer Elhauge

Print publication date: 2010

Print ISBN-13: 9780195390131

Published to Oxford Scholarship Online: May 2010

DOI: 10.1093/acprof:oso/9780195390131.001.0001

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American Health Care Policy and Politics

American Health Care Policy and Politics

Is Fragmentation a Helpful Category for Understanding Health Reform Experience and Prospects?

(p.343) 15 American Health Care Policy and Politics
The Fragmentation of U.S. Health Care

Theodore R. Marmor (Contributor Webpage)

Oxford University Press

This chapter addresses the past four decades of American health care politics, asking whether the idea of fragmentation provides a central and helpful analytical perspective. Part I reviews the highlights of health policy disputes from the 1970s to the 2000s. Part II places the United States in comparative perspective. Part III discusses the regulation versus competition debate that has been such a dominant part of American medical care discussion since the 1970s. Part IV discusses the issues raised by efforts to reform Medicare, and questions whether the theme of fragmentation illuminates those policy disputes. Part V concludes that fragmentation refers to many disparate features of American medical care and politics, and is illuminating only when tied to specific institutions, internests, and ideas.

Keywords:   health care politics, health care policy, comparative studies, fragmentation of delivery, financing, regulation, governmental institutions

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