Suchergebnisse

Confidence in American government has been declining for three decades. Three-quarters of Americans said they trusted the Federal government to do the right thing in 1964. Today, only a quarter do. Why the decline? Is this mistrust a healthy reflection of America's long-lasting skepticism of a strong state? Is mistrust a problem for the future of governance? Bringing together essays by leading Harvard scholars, this book explores the roots of mistrust. It first examines government's current scope, its actual performance, and citizens' perceptions of its performance. It then assesses many possible explanations that have been offered for the decline of trust, including the end of the Cold War, elevated expectations following World War II, a weakened economy, the effects of globalization, resentment over political scandals, and incompetence of bureaucrats. The book clarifies thinking about the sources of public disaffection. Mistrust, the contributors find, is largely unrelated to national economic conditions, to challenges of a global economy, to the Cold War, or to bumbling bureaucrats and venal politicians. Rather, they show that the most likely culprits are all around us—an interacting blend of cultural and political conflicts stirred by an increasingly corrosive news media

Frontmatter -- Contents -- Preface to the Second Edition -- Introduction -- Part I The Uninsured, Health Care Costs, and Public Programs -- The U.S. Health Care System: On a Road to Nowhere? -- Wanted: A Clearly Articulated Social Ethic for American Health Care -- From Bismarck to Medicare—A Brief History of Medical Care Payment in America -- The Sad History of Health Care Cost Containment as Told in One Chart -- The Unsurprising Surprise of Renewed Health Care Cost Inflation -- The Not-So-Sad History of Medicare Cost Containment as Told in One Chart -- Medicaid and Medicare: The Unanticipated Politics of Public Insurance Programs -- PART II Managed Care, Markets, and Rationing -- Bedside Manna -- Must Good HMOs Go Bad? The Commercialization of Prepaid Group Health Care -- Defending My Life -- Business vs. Medical Ethics: Conflicting Standards for Managed Care -- The Prostitute, the Playboy, and the Poet: Rationing Schemes for Organ Transplantation -- Ethics of Queuing for Coronary Artery Bypass Grafting in Canada -- Rationing in Practice: The Case of In Vitro Fertilization -- PART III International Perspectives and Emerging Issues -- Reforming the Health Care System: The Universal Dilemma -- Health Care in Four Nations -- Keeping Quality on the Policy Agenda -- What's Ahead for Health Insurance in the United States? -- Luxury Primary Care— Market Innovation or Threat to Access? -- Correspondence: Response to ''Luxury Primary Care'' -- Limiting Health Care for the Old -- Scapegoating the Aged: Intergenerational Equity and Age-Based Rationing -- Index to Authors -- About the Editors