title: Markets, Medicare, and making do: business strategies after national health care reform.
abstract: This essay examines the role of business health care purchasers in keeping market solutions at the center of the health system. One might assume that employers would have a clear ideological preference for market solutions, but big business managers are ambivalent about market interventions at both the firm and public policy levels. Although currently enthusiastic about market-oriented managed care, large employers have been periodically disappointed by firm-level market experiments during the past two decades. They viewed with skepticism the Republican proposal to apply private-sector market cures to the public Medicare and Medicaid, fearing that the proposals would accelerate cost-shifting to private business payers. Big business objections have been muted, however, by the organizational weakness so vividly illustrated during the national health reform debate.
authors.affiliation: Boston University, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Martin
mesh_terms: D003132:Commerce / Q000458:organization & administration*; D019058:Community Networks / Q000191:economics; D003361:Cost Allocation; D017046:Cost Savings / Q000379:methods; D006264:Health Benefit Plans, Employee / Q000639:trends; D006265:Health Care Coalitions; D018166:Health Care Reform / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration; D018854:Managed Competition / Q000639:trends*; D006278:Medicare / Q000458:organization & administration*; D009936:Organizational Innovation; D011057:Politics; D017149:Private Sector / Q000191:economics; D014481:United States