Examines how the American system of health care is responding to the ongoing needs of people with disabilities.
Since the passage in 1990 of the Americans with Disabilities Act, society has made considerable strides in improving the quality of life and the productivity of individuals with disabilities. At the same time, however, the American health care system has undergone considerable change, with some unforeseen consequences for those with disabilities.
Birenbaum analyzes all of the disability and health policy issues that have emerged from our reliance upon managed care. First, he examines how disability has been defined and redefined in social science and in government regulations. Then, he discusses the major changes in health care over the last decade—in particular, the financial and organizational principles behind managed care. After reviewing the structural advantages and disadvantages of managed care for people with disabilities, he concludes with observations on the future of health care for people with disabilities, particularly in the context of the quality of life and the possible functional outcomes following medical interventions.
Preface
Introduction
Disability, American Society, and Health Care
Medical Care Financing and Utilization for People with Disabilities
Full-Blown Managed Care
A Cost-Driven Delivery System and People with Disabilities
Contested Terrain: Access to Specialist and Hospital Stays
Disability, the Quality of Life, and the Quality of Managed Care
Managed Care and Centers of Excellence
Public Health Partnerships: Work in Progress
Protecting the Rights of Consumers
Some Unresolved Issues
Reviews
Birenbaum writes clearly and informatively about the cost-driven changes in health care organization, financing, and delivery and the ways in which these changes have impacted or may impact people with disabilities....A valuable, interesting, and well-written book about major changes in health care financing and delivery and the consequences of a managed care system for people with disabilities. Upper division undergraduates through professionals; two year technical program students.—Choice