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The Delegated Welfare State
This book explores the delegation of authority over American social programs to private actors. In the development of the American welfare state, policy-makers have often avoided direct governmental provision of benefits and services, turning instead to private actors for the governance of social programs. More recent versions of delegated governance seek also to create social welfare marketplaces in which consumers can choose from an array of private providers. This book examines both the reasons behind this persistent delegation of authority and the consequences. Focusing on the case study of Medicare—and, in particular, the 2003 Medicare Modernization Act—the book argues that fundamental contradictions in American public opinion help explain the prevalence of delegated governance. Americans want both social programs and small government, leaving policy-makers in a bind. To square the circle, policy-makers have contracted out public programs to non-state actors, including voluntary organizations and for-profit entities, as a way to mask the role of the state. Such arrangements also pull in interest group allies—the providers of these programs—who can help pass policies in a political landscape that is fraught with obstacles. Although delegated governance has been politically expedient, it has frequently come at the cost of effective administration and created problems of fraud and abuse. Social welfare marketplaces also suffer from the difficulties individuals have in making choices about the benefits they need. In probing both the causes and consequences of delegated governance, this book offers a novel interpretation of both American social welfare politics and the nature of the American state.
eBook
The business of Civil War : military mobilization and the state, 1861-1865
This wide-ranging, original account of the politics and economics of the giant military supply project in the North reconstructs an important but little-known part of Civil War history. Drawing on new and extensive research in army and business archives, Mark R. Wilson offers a fresh view of the wartime North and the ways in which its economy worked when the Lincoln administration, with unprecedented military effort, moved to suppress the rebellion.
This task of equipping and sustaining Union forces fell to career army procurement officers. Largely free from political partisanship or any formal free-market ideology, they created a mixed military economy with a complex contracting system that they pieced together to meet the experience of civil war. Wilson argues that the North owed its victory to these professional military men and their finely tuned relationships with contractors, public officials, and war workers.
Wilson also examines the obstacles military bureaucrats faced, many of which illuminated basic problems of modern political economy: the balance between efficiency and equity, the promotion of competition, and the protection of workers' welfare. The struggle over these problems determined the flow of hundreds of millions of dollars; it also redirected American political and economic development by forcing citizens to grapple with difficult questions about the proper relationships among government, business, and labor.
Students of the American Civil War will welcome this fresh study of military-industrial production and procurement on the home front—long an obscure topic.
eBook
Medical Research for Hire
Today, more than 75 percent of pharmaceutical drug trials in the United States are being conducted in the private sector. Once the sole province of academic researchers, these important studies are now being outsourced to non-academic physicians.
According to Jill A. Fisher, this major change in the way medical research is performed is the outcome of two problems in U.S. health care: decreasing revenue for physicians and decreasing access to treatment for patients. As physicians report diminishing income due to restrictive relationships with insurers, increasing malpractice insurance premiums, and inflated overhead costs to operate private practices, they are attracted to pharmaceutical contract research for its lucrative return. Clinical trials also provide limited medical access to individuals who have no or inadequate health insurance because they offer \"free\" doctors' visits, diagnostic tests, and medications to participants. Focusing on the professional roles of those involved, as well as key research practices, Fisher assesses the risks and advantages for physicians and patients alike when pharmaceutical drug studies are used as an alternative to standard medical care.
A volume in the Critical Issues in Health and Medicine series, edited by Rima D. Apple and Janet Golden
eBook
States, Citizens and the Privatisation of Security
Recent years have seen a growing role for private military contractors in national and international security. To understand the reasons for this, Elke Krahmann examines changing models of the state, the citizen and the soldier in the UK, the US and Germany. She focuses on both the national differences with regard to the outsourcing of military services to private companies and their specific consequences for the democratic control over the legitimate use of armed force. Tracing developments and debates from the late eighteenth century to the present, she explains the transition from the centralized warfare state of the Cold War era to the privatized and fragmented security governance, and the different national attitudes to the privatization of force.
eBook
The rise of legal services outsourcing : risk and opportunity
Mary Lacity, Leslie Willcocks and Andrew Burgess present practices used by Legal Process Outsourcing (LPO) clients, providers and advisors to realize value from LPO services. The book is based on data from 27 providers, interviews with clients and lessons learned from prior Information Technology Outsourcing (ITO) and Business Process Outsourcing (BPO) research. Based on the authors' deep understanding of the evolution of ITO and BPO, 'The Rise of Legal Process Outsourcing' addresses the transformation of legal work, LPO strategy, provider selection and contractual governance, as well as predicting the trends that will come to shape the LPO market.
Book
Measuring the Performance of the Hollow State
Measuring the Performance of the Hollow Stateis the first in-depth look at the influence of performance measurement on the effectiveness of the federal government. To do this, the authors examine the influence of the Government Performance and Results Act of 1993 (with consideration of the later Program Assessment Rating Tool of 2002) on federal performance measurement, agency performance, and program outcomes. They focus a systematic examination on five agencies in the U.S. Department of Health and Human Services-the Food and Drug Administration, the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, the National Institutes of Health, and the Indian Health Service. Besides representing a wide range of federal government organizational structures and program formats, these agencies offer a diverse array of third-party arrangements including states, native American tribes, scientists, medical schools, and commercial and nonprofit health care intermediaries and carriers. Exploring the development of performance measures in light of widely varying program mandates, the authors look at issues that affect the quality of this measurement and particularly the influence of program performance by third parties. They consider factors such as goal conflict and ambiguity, politics, and the critical role of intergovernmental relations in federal program performance and performance measurement. Through their findings, they offer illumination to two major questions in public management today-what are the uses and limitations of performance measurement as a policy and management tool and how does performance measurement work when applied to the management of third-party government? While scholars and students in public administration and governmental reform will find this book of particular interest, it will also be of use to anyone working in the public sector who would like to have a better understanding of performance measurement.
eBook