The Medical Delivery Business: Health Reform, Childbirth, and the Economic Order

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Rutgers University Press, 2004 - Medical - 252 pages

Americans at the end of the twentieth century worried that managed care had fundamentally transformed the character of medicine. In The Medical Delivery Business, Barbara Bridgman Perkins uses examples drawn from maternal and infant care to argue that the business approach in medicine is not a new development. Health care reformers throughout the century looked to industrial, corporate, and commercial enterprises as models for the institutions, specialties, and technological strategies that defined modern medicine.

In the case of perinatal care, the business model emphasized specialized over primary care, encouraged the use of surgical and technological procedures, and unnecessarily turned childbirth into an intensive care situation. Active management techniques, for example, encouraged obstetricians to accelerate labor with oxytocin to augment their productivity. Despite the achievements of the childbirth and women's health movement in the 1970s, aggressive medical intervention has remained the birth experience for millions of American women (and their babies) every year.

The Medical Delivery Business challenges the conventional view that a dose of the market is good for medicine. While Perkins is sympathetic to the goals of progressive and feminist reformers, she questions whether their strategies will succeed in making medicine more equitable and effective. She argues that the medical care system itself needs to be fundamentally "re-formed," and the reforms must be based on democracy, caring, and social justice as well as economics.

 

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Contents

Business Models and Medical Interventions
1
The ECOnomic Production of Childbirth
15
Medical Specialism and EarlyTwentiethCentury
17
Three Dividing Labor Industrializing Birth
34
Designing Delivery Systems
53
Five Regional Health Planning and Economic Organization
69
Six Perinatal Regionalization and Economic Order
85
Providers Procedures
103
of Labor
138
Reforming Medicine Reforming Reform
156
Copyright

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About the author (2004)

Barbara Bridgman Perkins is an independent scholar, health care consultant, and one of the original contributors to Our Bodies, Ourselves. Founded in 1936, Rutgers University Press is a non-profit academic publishing house operating under the auspices of Rutgers, the State University of New Jersey, and supported by its Board of Governors. The Press publishes titles in African American studies, Asian American studies, Asian studies, art, cultural studies, environmental studies, film, gay and lesbian studies, health, history, literature, medicine, New Jersey and regional studies, political science, psychology, religion, sociology, science, and women's studies. Rutgers University Press is a member of the Association of American University Presses.

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