TY - BOOK ID - 40858904 TI - Unmanageable Care PY - 2014 SN - 0814764991 9780814764992 9780814770702 0814770703 9780814724910 0814724914 9780814770313 0814770312 PB - New York, NY DB - UniCat KW - Medical care KW - Medical policy KW - Health care reform KW - Privatization KW - Denationalization KW - Privatisation KW - Contracting out KW - Corporatization KW - Government ownership KW - Health reform KW - Health system reform KW - Healthcare reform KW - Medical care reform KW - Reform of health care delivery KW - Reform of medical care delivery KW - Health insurance KW - Health care policy KW - Health policy KW - Medicine and state KW - Policy, Medical KW - Public health KW - Public health policy KW - State and medicine KW - Science and state KW - Social policy KW - Delivery of health care KW - Delivery of medical care KW - Health care KW - Health care delivery KW - Health services KW - Healthcare KW - Medical and health care industry KW - Medical services KW - Personal health services KW - Government policy KW - BUSINESS & ECONOMICS / Insurance / Health. KW - SOCIAL SCIENCE / Sociology / General. KW - SOCIAL SCIENCE / Anthropology / Cultural. KW - Delivery of Health Care KW - Community-Based Distribution KW - Contraceptive Distribution KW - Delivery of Healthcare KW - Dental Care Delivery KW - Distribution, Non-Clinical KW - Distribution, Nonclinical KW - Distributional Activities KW - Healthcare Delivery KW - Healthcare Systems KW - Non-Clinical Distribution KW - Nonclinical Distribution KW - Delivery of Dental Care KW - Health Care KW - Health Care Delivery KW - Health Care Systems KW - Activities, Distributional KW - Activity, Distributional KW - Care, Health KW - Community Based Distribution KW - Community-Based Distributions KW - Contraceptive Distributions KW - Deliveries, Healthcare KW - Delivery, Dental Care KW - Delivery, Health Care KW - Delivery, Healthcare KW - Distribution, Community-Based KW - Distribution, Contraceptive KW - Distribution, Non Clinical KW - Distributional Activity KW - Distributions, Community-Based KW - Distributions, Contraceptive KW - Distributions, Non-Clinical KW - Distributions, Nonclinical KW - Health Care System KW - Healthcare Deliveries KW - Healthcare System KW - Non Clinical Distribution KW - Non-Clinical Distributions KW - Nonclinical Distributions KW - System, Health Care KW - System, Healthcare KW - Systems, Health Care KW - Systems, Healthcare KW - Puerto Rico. KW - E-books UR - https://www.unicat.be/uniCat?func=search&query=sysid:40858904 AB - In Unmanageable Care, anthropologist Jessica M. Mulligan goes to work at anHMO and records what it’s really like to manage care. Set at a health insurancecompany dubbed Acme, this book chronicles how the privatization of the healthcare system in Puerto Rico transformed the experience of accessing andproviding care on the island. Through interviews and participant observation,the book explores the everyday contexts in which market reforms were enacted.It follows privatization into the compliance department of a managed careorganization, through the visits of federal auditors to a health plan, and intothe homes of health plan members who recount their experiences navigating thenew managed care system.Inthe 1990s and early 2000s, policymakers in Puerto Rico sold off most of theisland’s public health facilities and enrolled the poor, elderly and disabledinto for-profit managed care plans. These reforms were supposed to promoteefficiency, cost-effectiveness, and high quality care. Despite the optimisticpromises of market-based reforms, the system became more expensive, not moreefficient; patients rarely behaved as the expected health-maximizing informationprocessing consumers; and care became more chaotic and difficult to access.Citizens continued to look to the state to provide health services for thepoor, disabled, and elderly. This book argues that pro-market reforms failed todeliver on many of their promises.Thehealth care system in Puerto Rico was dramatically transformed, just notaccording to plan. ER -