By Jessica M. Mulligan
ISBN-10: 0814724914
ISBN-13: 9780814724910
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Sample text
Furthermore, managed care in Medicare costs 13% more to provide than traditional fee-for-service Medicare (Zarabozo and Harrison 2009, W55). The irony is that programs that were aimed at streamlining and downsizing government involvement in the provision of health care had the opposite effect. As various anthropological studies have shown (see, for example, Horton et al. 2001; Lamphere 2005; Stan 2007; Waitzkin et al. 2002), the process of privatizing health care is often fraught with contradiction and unintended consequences.
It is important to note that privatization does not eliminate government, but rather it changes its form (Barry et al. 1996, 14; Ferguson and Gupta 2002; Shore and Wright 1997, 28). When health programs were privatized in Puerto Rico and the United States, the government was still concerned with how patients were cared for and how public money was spent. So regulatory agencies employed techniques for “governing from afar” like audits and performance measurement (Clarke 2004; Rose 1996, 43) that allowed oversight to continue in an altered form.
This time writing about himself in the third person, Ashford went on to claim that his discovery of the hookworm parasite was significant for all of the Americas: He began to think geographically. Of course he must be very prudent, but—the anemia pandemic in Puerto Rico could not be limited to this one little island. It was all through these latitudes. It must be. He had heard of the indolence of Mexicans, of Central Americans, of people everywhere in the old Spanish Main. He could not say that their indolence was caused by disease.