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Designin high-cost medicine hospital surveys, health planning, and the paradox of progressive reform

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  • Perkins, B.B.

Abstract

Inspired by social medicine, some progressive US health reforms have paradoxically reinforced a business model of high-cost medical delivery that does not match social needs. In analyzing the financial status of their areas' hospitals, for example, city-wide hospital surveys of the 1910s through 1930s sought to direct capital investments and, in so doing, control competition and markets. The 2 national health planning programs that ran from the mid-1960s to the mid-1980s continued similar strategies of economic organization and management, as did the so-called market reforms that followed. Consequently, these reforms promoted large, extremely specialized, capital-intensive institutions and systems at the expense of less complex (and less costly) primary and chronic care. The current capital crisis may expose the lack of sustainability of such a model and open up new ideas and new ways to build health care designed to meet people's health needs.

Suggested Citation

  • Perkins, B.B., 2010. "Designin high-cost medicine hospital surveys, health planning, and the paradox of progressive reform," American Journal of Public Health, American Public Health Association, vol. 100(2), pages 223-233.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2008.155838_2
    DOI: 10.2105/AJPH.2008.155838
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