Health Care Regulation in America: Complexity, Confrontation, and Compromise

Regulation shapes all aspects of America's fragmented health care industry, from the flow of dollars to the communication between physicians and patients. It is the engine that translates public policy into action. While the health and lives of patients, as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. Government agencies at the federal, state, and local levels direct portions of the industry, but hundreds of private organizations do so as well. Some of these overseers compete with one another, some conflict, and others collaborate. Their interaction is as important to the provision of health care as are the laws and rules they implement. Health Care Regulation in America is a guide to this regulatory maze. It succinctly recaps the past and present conflicts that have guided the oversight of each industry segment over the past hundred years and explains the structure of regulation today. To make the system comprehensible, this book also presents the sweep of regulatory policy in the context of the interests, values, goals, and issues that guide it. Chapters cover the process of regulation and each key area of regulatory focus - professionals, institutions, financing arrangements, drugs and devices, public health, business relationships, and research. In a uniquely American way, the system thrives on confrontation between competing interests but survives by engendering compromise. Robert Field shows that health care regulation is an inexorable force that nurtures as well as restricts the enterprise of American health care. For the student, practitioner, executive, policy analyst, or concerned citizen, this book is an invaluable guide to the policy, politics, and practice of an industry that directly touches us all.