The Delegated Welfare State: Medicare, Markets, and the Governance of Social Policy by Kimberly J. Morgan

The Delegated Welfare State: Medicare, Markets, and the Governance of Social Policy

byKimberly J. Morgan, Andrea Louise Campbell

Paperback | October 15, 2011

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Why are so many American social programs delegated to private actors? And what are the consequences for efficiency, accountability, and the well-being of beneficiaries? The Delegated Welfare State examines the development of the American welfare state through the lens of delegation: howpolicymakers have avoided direct governmental provision of benefits and services, turning to non-state actors for the governance of social programs. Utilizing case studies of Medicare and the 2009-10 health care reform, Morgan and Campbell argue that the prevalence of delegated governance reflects the powerful role of interest groups in American politics, the dominance of Congress in social policymaking, and deep contradictions in Americanpublic opinion. Americans want both social programs and small government, leaving policy makers in a bind. Contracting out public programs to non-state actors masks the role of the state and enlists private allies who push for passage. Although delegated governance has been politically expedient,enabling the growth of government programs in an anti-government political climate, it raises questions about fraud, abuse, administrative effectiveness, and accountability. In probing both the causes and consequences of delegated governance, The Delegated Welfare State offers a novel interpretationof both American social welfare politics and the nature of the American state.

About The Author

Kimberly J. Morgan is Associate Professor of Political Science at George Washington University. Andrea Louise Campbell is Associate Professor of Political Science at Massachusetts Institute of Technology.
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Title:The Delegated Welfare State: Medicare, Markets, and the Governance of Social PolicyFormat:PaperbackDimensions:328 pages, 9.25 × 6.12 × 0.68 inPublished:October 15, 2011Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:0199730350

ISBN - 13:9780199730353

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Table of Contents

List of FiguresList of TablesAbbreviationsAcknowledgements1. IntroductionThe Concept of Delegated GovernanceThe Case Study of MedicareThe Methodology and Organization of This Book2. Exploring the Delegated Welfare StateConceptualizing the Delegated Welfare StateWhat Does the Delegated Welfare State Look Like?A Cross-National Perspective on Delegated GovernanceWhy Did the Delegated Welfare State Emerge in the US?Does It Matter How Social Programs Are Administered?Conclusion3. Medicare and the Delegated Welfare State in the Post-War EraThe Emergence of the Delegated Welfare StateDelegating the Governance of MedicareConclusion4. The Rise of the Market Reform MovementThe Complex Politics of Welfare State PrivatizationThe Free Market Movement in Health CareThe Politics of MarketizationConclusion5. Crafting the Medicare Modernization Act of 2003Delegated Governance in the MMAThe Political Context: Polarization, Electoral Competition, and Partisan ConflictProgram Design: The Turn to Delegated GovernancePassing the MMA in 2003The Politics of Delegated Governance6. Administering the Delegated Welfare State The Cases of Medicare and the 2003 Medicare Modernization ActDelegated Governance in Traditional Medicare: A Mixed PictureCreating a Social Welfare Marketplace: The 2003 MMAConclusion7. The Delegated Welfare State and Policy FeedbacksThe Feedbacks That Haven't Happened (Yet)The Feedbacks that Did Happen: Public Demobilization and Issue PreemptionConclusion8. Citizens, Consumers, and the Market ModelConsumers and the Requirements of the Market ModelSenior Consumers and Part D DecisionmakingPart D Effectiveness and Senior Welfare: Mixed EvidenceVulnerable Populations and Redistribution IssuesConclusion9. Conclusion: Delegated Governance, Past, Present, and FutureImplications for Thinking about the American StateThe 2009-2010 Health Care Debate: A Fight about GovernanceAppendix A. Data SourcesInterviewsMMA Panel SurveyWisconsin Advertising Project DataAppendix B. Supplementary TablesNotesIndex