{"product_id":"unmanageable-care-an-ethnography-of-health-care-privatization-in-puerto-rico-1","title":"Unmanageable Care","description":"\u003cp\u003eIn Unmanageable Care, anthropologist Jessica M. Mulligan goes to work at an\u003cbr\u003e\nHMO and records what it’s really like to manage care. Set at a health insurance\u003cbr\u003e\ncompany dubbed Acme, this book chronicles how the privatization of the health\u003cbr\u003e\ncare system in Puerto Rico transformed the experience of accessing and\u003cbr\u003e\nproviding care on the island. Through interviews and participant observation,\u003cbr\u003e\nthe book explores the everyday contexts in which market reforms were enacted.\u003cbr\u003e\nIt follows privatization into the compliance department of a managed care\u003cbr\u003e\norganization, through the visits of federal auditors to a health plan, and into\u003cbr\u003e\nthe homes of health plan members who recount their experiences navigating the\u003cbr\u003e\nnew managed care system.\u003cbr\u003e\nIn\u003cbr\u003e\nthe 1990s and early 2000s, policymakers in Puerto Rico sold off most of the\u003cbr\u003e\nisland’s public health facilities and enrolled the poor, elderly and disabled\u003cbr\u003e\ninto for-profit managed care plans. These reforms were supposed to promote\u003cbr\u003e\nefficiency, cost-effectiveness, and high quality care. Despite the optimistic\u003cbr\u003e\npromises of market-based reforms, the system became more expensive, not more\u003cbr\u003e\nefficient; patients rarely behaved as the expected health-maximizing information\u003cbr\u003e\nprocessing consumers; and care became more chaotic and difficult to access.\u003cbr\u003e\nCitizens continued to look to the state to provide health services for the\u003cbr\u003e\npoor, disabled, and elderly. This book argues that pro-market reforms failed to\u003cbr\u003e\ndeliver on many of their promises.The\u003cbr\u003e\nhealth care system in Puerto Rico was dramatically transformed, just not\u003cbr\u003e\naccording to plan.\u003c\/p\u003e","brand":"New York University Press","offers":[{"title":"Default Title","offer_id":54191806447960,"sku":null,"price":83.99,"currency_code":"EUR","in_stock":true}],"url":"https:\/\/agendabookshop.com\/products\/unmanageable-care-an-ethnography-of-health-care-privatization-in-puerto-rico-1","provider":"Agenda Bookshop","version":"1.0","type":"link"}