Health Policy Commons^™

Organizational Structure And Professional Norms In An Alternative Health Care Setting: Physicians In Health Maintenance Organizations, Judith K. Barr, Marcia K. Steinberg

The Journal of Sociology & Social Welfare

The development of new organizational forms for the delivery of health and medical care in the U.S. includes health maintenance organizations (HMOs), designed to provide a set of comprehensive basic health services to a defined population for a fixed prepaid premium. As complex organizations, HMOs have the potential for limiting the autonomy of professionals working in them. This paper describes the legal requirements and organizational mechanisms under which physicians practice in HMOs and considers the potential for conflict between the organization and professional norms.

On the basis of document and interview data from nine HMOs, it appears that mechanisms developed …

The Paradoxes Of Health Planning, Bonnie Morel Edington

The Journal of Sociology & Social Welfare

The National Health Planning Act of 1974 designated 200 Health Systems Agencies (HSAs) nationally and a State Health Planning and Development Agency in each state. Components of the law are analyzed to illustrate its ambiguities and contradictions. The components analyzed are: the findings which led to the passage of the law; the law's purpose; the ten national health priorities; the National Guidelines for Health Planning; the purposes of the HSAs and the data they are to assemble and analyze. The major contradiction is that agencies designated to focus on cost containment in health care are expected to make health care …