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Barriers to New Competition
Their Character and Consequences in Manufacturing Industries
Joe S. Bain
Harvard University Press

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Healthy Markets?
The New Competition in Medical Care
Mark A. Peterson, ed.
Duke University Press, 1999
When federal and state policy makers’ efforts to enact sweeping health care reform in the mid-1990s ended in stalemate, the private sector unleashed initiatives that have affected virtually every aspect of health care. With updated essays first published in issues of the Journal of Health Politics, Policy and Law, Healthy Markets? offers the most comprehensive and critical examination yet found in a single volume of the economic, political, and social implications of this recent market transformation of health care in the United States.
With original contributions from leading social science health policy analysts, this volume addresses the full context of health system change. Believing that the analysis of health care change is too important to be left to economists alone, Mark A. Peterson has collected a mulitdisciplinary group of experts who revisit the contentious debate over the market approaches to health care and consider the disparate effects of these approaches on cost, quality, and coverage of both managed care and Medicaid and Medicare. While market enthusiasts applaud the enhanced efficiency, reduced excess capacity, and abatement of the decades-long health care cost explosion, a backlash has emerged among many providers and the public against the perceived excesses of the market: diminished access to care, commercialization of the physician-patient relationship, and exacerbated inequality. Contributors assess these varied responses while examining the impact that market-based applications are likely to have for future health policy making, the significance of the U.S. experience for policy makers abroad, and the lessons that these changes might provide for thinking sensibly about the future of our health care system.
This volume will be useful for public policy analysts, economists, social scientists, health care providers and administrators, and others interested in the future—and in understanding the past—of American health care.

Contributors. Gary S. Belkin, Lawrence D. Brown, Robert G. Evans, Martin Gaynor, Paul B. Ginsburg, Marsha Gold, Theodore R. Marmor, Cathie Jo Martin, Jonathan B. Oberlander, Mark V. Pauly, Mark A. Peterson, Thomas Rice, Deborah A. Stone, William B. Vogt, Kenneth E. Thorpe

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The New Competition
Institutions of Industrial Restructuring
Michael Best
Harvard University Press, 1990

Why is America losing its competitive edge in basic industries ranging from automobile manufacture to consumer electronics? The reason, Michael Best shows, is the rigid command and control structures that are typical of big business in America. America firms lack the organizational flexibility of the "new competition" practiced by companies in Italy, West Germany, and Japan. The secret to the success of these foreign firms is that they are organized from top to bottom to pursue continuous improvements in methods, products, and processes. They seek competitive advantage not through lowest-cost production but through superior product design. This requires an unusual degree of organizational flexibility, which in turn demands organizational commitments to problem solving, constant attention to detail, and an integration of thought and action in the work place.

The New Competition posits a strategic tension between market competition and cooperation in successful industrial societies. Instead of bargaining with suppliers and customers at arm's length, firms can forge consultative relations with them, facilitating the flow of valuable advice, suggestions, and information and crucially modifying a key processor design. Instead of engaging in price rivalry, companies can pursue product-related rivalries that increase their international competitiveness. Best envisions a new role for national industrial policy—one not of bailing out sick firms in dying industries but of shaping industrial sectors and markets. It would encourage firms to cooperate in terms of the form that competition takes, one that involves products instead of prices.

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