This important new study explores how American health care evolved in the 1990s, as well as the changes in public support and policy. Birenbaum examines where the interests of consumers and professionals have dovetailed and where they differ. He considers the health care system's future and suggested ways the system must be adjusted to provide better and wider coverage at reasonable costs. This volume is essential reading for scholars, students, and professionals in the medical field, as well as general readers concerned with health care issues.The 90s saw the country moving toward a realization that health care had become unaffordable-or an enormous financial burden for people with otherwise adequate incomes. Health care providers and consumers alike worried that the problem was becoming uncontrollable. Doctors saw their autonomy and control eroded, employers saw their costs rising significantly, the costs began shifting to employees, and alternative approaches to cost containment were explored.

PrefaceIntroductionHealth Care on the National AgendaWhat's Behind the Changing Doctor-Patient RelationshipDriving Down Costs and Professional AutonomyThe Reorganization of Health Care DeliveryManaged Care and the Profession's Tarnished Jewels in the Crown--Academic Health CentersDoctors Respond to the Dark Side of Managed CareHow Managed Care Is Shaping Medical PracticeHopes for ReformThe Future of American MedicineIndex