Tuesday, October 25, 2011

The Delegated Welfare State: Medicare, Markets, and the Governance of Social Policy


I've been reading this new book about privatization of health care - the authors are Kimberly J. Morgan and Andrea Louise Campbell.  It is an excellent academic monograph (Oxford University Press).

This is a terrific contribution to the literature about privatization of government services - thorough and clear historical narrative about various government health care programs and legislation.  The book has an appropriately critical slant but is not argumentative.  The empirical sections (surveys) are fairly compelling.  For those interested in Obamacare, it receives less attention (due to the date of writing) than the Bush-era prescription drug benefit.

The central thesis is that voters want contradictory things from the government - wraparound services but also small government. Legislators turn to privatization as an attempt to meet these contradictory goals, providing a service without hiring more civil servants to run the programs.  The results are mixed at best, the authors conclude, but the impetus is primarily political.  I highly recommend this book.

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