Health care policy and proposals for national health care reform have become some of the most contentious political issues of the decade. Garland Publishing announces a new series addressing the most significant issues in the area of health care policy and the business of health care in the United States. books in this multidisciplinary series will include studies of health care practice, the health care business, the implications of multicultural perspectives on health care for public policy, the impact of insurance on health care, and debates over national health care policy, including health care reform. This collection of timely works will offer significant scholarly perspectives on one of the most important issues in public policy. Profiles Medicaid doctors Early studies of physician participation in Medicaid programs have suggested that such participation is based on economic self-interest, while recent studies have observed that participation is complicate by shortages of office-based physicians in low income areas. This study sheds new light on the issues of physician participation, finding that physicians who care for poor Medicaid patients are more likely than other physicians to have marginal social and professional status. Examines social, medical, and economic barriers Marginality is a social condition associated with long-standing social and economic barriers and is the result of formal and informal discrimination. Individuals of marginal social status such as women, foreign born, and of minority racial/ethnic background, find that opportunities for advancement within the medical profession are limited. As a result, physicians of marginal social status are morelikely to have marginal professional status, such as foreign medical education, pediatric specialization, lack of board certification, and institutional practice, and are more likely to practice in areas of high poverty rates and minority concentration. Marginal professional status and characteristics have a strong direct effect on Medicaid participation. The study discusses the policy implications of these findings in light of the recent restructuring of Medicaid through the expansion of managed care.
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