title: Advancing the business creed? The framing of decisions about public sector managed care.
abstract: Relatively little research has clarified how executives of for-profit healthcare organisations frame their own motivations and behaviour, or how government officials frame their interactions with executives. Because managed care has provided an organisational structure for health services in many countries, we focused our study on executives and government officials who were administering public sector managed care services. Emphasising theoretically the economic versus non-economic motivations that guide economic behaviour, we extended a long-term research project on public sector Medicaid managed care (MMC) in the United States. Our method involved in-depth, structured interviews with chief executive officers of managed care organisations, as well as high-ranking officials of state government. Data analysis involved iterative interpretation of interview data. We found that the rate of profit, which proved relatively low in the MMC programme, occupied a limited place in executives' self-described motivations and in state officials' descriptions of corporation-government interactions. Non-economic motivations included a strong orientation toward corporate social responsibility and a creed in which market processes advanced human wellbeing. Such patterns contradict some of the given wisdom about how corporate executives and government officials construct their reality.
authors.affiliation: Department of Sociology, Robert Wood Johnson Foundation Center for Health Policy, University of New Mexico, Albuquerque, New Mexico 87131, USA. waitzkin@unm.edu
authors.forename: Howard
authors.initials: H
authors.lastname: Waitzkin
authors.forename: Joel
authors.initials: J
authors.lastname: Yager
authors.forename: Richard
authors.initials: R
authors.lastname: Santos
mesh_terms: D000533:Altruism; D004465:Economic Competition; D006269:Health Facilities, Proprietary / Q000191:economics / Q000458:organization & administration*; D006291:Health Policy; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*; D009042:Motivation; D011057:Politics; D017150:Public Sector / Q000191:economics / Q000458:organization & administration*; D012941:Social Responsibility; D012962:Sociology, Medical; D014481:United States