The Health Marketplace: New York City, 1990-2010

Abstract

Health care provision in the United States remains a critical policy issue. Despite large-scale organizational transformations in hospitals, changes in the ways that health care is delivered, and changes in the relations between patients and the staffs who provide health care services, health institutions remain financially unstable even as they have grown in size. Mergers and new networks and systems have emerged, and revenue streams continue to grow. Experts no longer view such developments as holding the answer to continuing problems of the health care system. Focusing on changes in the health care sector in New York City during the 1990s, this volume considers physicians and other health care workers, primary and ambulatory care sites, and hospitals and medical centers. It explores the impact of institutional realignments and managed care in New York City. It examines the accelerated destabilization of health care financing and delivery at the end of the twentieth century in the nation at large as well as in New York State and New York City. Ginzberg and his colleagues describe what might happen in the next decade in the nation's largest metropolis and locate the probable outcome in the space between these two extremes. They focus on how the health marketplace may be altered by 2010 when it faces its greatest challenges, a year before the first members of the baby boom generation become eligible for Medicare. This literate and informative volume elucidates changes that have occurred in the health care sector during the decade of the 1990s and offers an expert assessment of what might happen over the next decade. Policymakers, health care officials, and medical personnel will find this highly informative reading. Eli Ginzberg is A. Barton Hepburn Professor Emeritus at the Graduate School of Business, and Director of the Eisenhower Center for the Conservation of Human Resources at Columbia University. His work in social policy, health care, human resources, the special needs of the poor, the young and the aged, place Ginzberg in a special category: activist scholar rather than academic-turned-activist. Howard Berliner is associate professor, Program in Health Services Management and Policy, Milano Graduate School of Management and Urban Policy, New School for Social Research. Panos Minogiannis is a political science doctoral candidate in the division of Sociomedical Sciences, Columbia University and a research associate at the Eisenhower Center. Miriam Ostow was the long term chief of health policy studies at the Eisenhower Center and co-author of many of its earlier publications on health policy.