No one misses the onslaught of claims about reforming modern medical care. How doctors should be paid, how hospitals should be paid or governed, how much patients should pay when sick in co-payments, how the quality of care could be improved, and how governments and other buyers could better control the costs of care � all find expression in the explosion of medical care conference proceedings, op-eds, news bulletins, journal articles, and books.

This collection of articles takes up a key set of what the author regards as particularly misleading fads and fashions � developments that produce a startling degree of foolishness in contemporary discussions of how to organize, deliver, finance, pay for and regulate medical care services in modern industrial democracies.

The policy fads addressed include the celebration of explicit rationing as a major cost control instrument, the belief in a "basic package" of health insurance benefits to constrain costs, the faith that contemporary cross-national research can deliver a large number of transferable models, and the notion that broadening the definition of what is meant by health will constitute some sort of useful advance in practice.

Contents:

• Fads in Medical Care Policy and Politics: The Rhetoric and Reality of Managerialism
• How Not to Think About �Managed Care�
• Medical Care and Public Policy: The Benefits and Burdens of Asking Fundamental Questions
• Medicare and Political Analysis: Omissions, Understandings, and Misunderstandings
• Comparative Perspectives and Policy Learning in the World of Health Care
• How Not to Think About Medicare Reform

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Readership: Graduate students in management, nursing, medicine, and social sciences; science researchers or writers; medical practitioners and laypersons.

�Although Marmor's essays offer brilliant insights into the rhetoric of health policy, they also provide clear descriptions of how health care systems actually work and the problems they face. The essay on �How Not To Think About Managed Care� offers an excellent analysis of how managed care plans in fact function. It is particularly useful for helping students understand this complex subject.�

Timothy Stoltzfus Jost Robert L Willett Family Professor Washington and Lee University School of Law

�Marmor is committed to universal access to quality care and has great sympathy for those who work in health systems. He is also a great skeptic, an essential characteristic of good public servants. He provides practical guidance, particularly to public service advisers, and also to health managers, professional service providers and media commentators. He encourages all to test the claims of the �reform� advocates, to consider the political and other interests involved, and to take into account the context in which different national health systems operate, and their distinct histories and cultures.�

Andrew Podger National President Institute of Public Administration Australia

�This collection of essays showcases Marmor at his most trenchant and irreverent best; skewering sacred cows, debunking health care fads, and exposing the shallowness of managerial jargon indiscriminately applied to health care. Only one whose sharp eye has been trained for years on the way health care delivery has � and hasn�t � worked all over the world would have enough perspective to write this book. Marmor�s sharp eye is matched by a sharp intellect and tongue, and the result is not only illuminating, but pure pleasure to read.�

Frances Miller Neal M. Pike Scholar Boston University School of Law

�Marmor, one of the most original analysts of public policy and health systems, both nationally and internationally, has brought together some of his most perceptive articles. His insights are astute and seldom predictable.�

Marcia Angell Senior Lecturer, Department of Social Medicine Harvard Medical School

�Marmor�s deep appreciation of the political base of health policy � in values, interests and institutions � has made him a trenchant and eloquent critic of attempts to develop and promulgate universally applicable solutions to the fundamental challenges in this arena. Written over the past seven years, the essays compiled in this short book draw on his four decades of experience, research and reflection, and represent a fine distillation of the best of his critiques. They make salutory reading for practitioners and students of health policy alike.�