Providing a fascinating overview of healthcare spending and cost-containment mechanisms in the US, this book explores the consequences of managed care for the community with particular attention paid to doctor-patient relationships. The author studies this significant relationship from a social perspective arguing that shifting financial risk onto doctors in a profit-making system seriously damages patient trust. In addition this undermines overall social capital, which in turn has been linked to health outcomes.

Including case study examples and policy implications, this insightful text explores an important, though little-discussed outcome of healthcare reform and will be a welcome addition to the current healthcare literature.