“A telling ethnography of the privatization of health care in Puerto Rico. Written from within the system of managed care, Mulligan’s impressive understanding of historical, cultural, economic, entrepreneurial, and moral aspects of reform paints a troubling picture of what is wrong with market approaches to care. Clear, timely, and insightful, Unmanageable Care contributes importantly to the medical anthropology of health care. It also goes beyond that to illustrate the limits and failures of market approaches to manage caregiving that are regularly overlooked by health policy experts with unfortunate results. An important book!”
—Arthur Kleinman, M.D., Esther and Sidney Rabb Professor of Anthropology, Harvard University
"A persuasive account and `insider’s’ view of how Managed Care really works. Managed Care, Jessica Mulligan argues, is really `ungovernable’ care. The assumption that `rational consumers’ can exercise `choice’ ignores the way ordinary people understand and deal with their health care issues. `Consumers’ see themselves as retired workers, mothers, or those who have chronic diseases like diabetes. `Choice’ is bewildering or limited. `Satisfaction’ boils down to surveys that code statements like `I can’t complain’ and omit narratives about struggles to get better care. Mulligan argues we need to diagnose these ills that characterize neoliberal models of healthcare reform before we can work to change them."
—Louise Lamphere, Distinguished Professor of Anthropology Emerita, University of New Mexico
“Mulligan does an excellent job of, as she puts it, ‘tak[ing] seriously’ the potential of market-based solutions to reducing healthcare costs….While methodologically appealing to anthropologists, this book also has broader implications for those seeking healthcare solutions for disadvantaged populations in resource-constrained settings.”
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