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Papers by Howard Berliner

Social Science & Medicine. Part D: Medical Geography, Jun 1, 1979

International Journal of Health Services, Apr 1, 2002

Routledge eBooks, Oct 8, 2021

International Journal of Health Services, Apr 1, 2001

Labor unions that represent health care workers encounter unique circumstances. This study focuse... more Labor unions that represent health care workers encounter unique circumstances. This study focuses on 1199-the largest health care workers' union in the United States, based in New York City-and describes how the union and its National Benefit Fund have structured a managed indemnity health insurance program that provides extensive benefits for its members. The authors detail the workings of the National Benefit Fund and the ways in which it can improve the health care of its members through its union structure. The Fund represents a model for improving the provision of health care to Americans.

International Journal of Health Services, Oct 1, 1987

In this article we examine the previously little-studied development in US. health care-the growt... more In this article we examine the previously little-studied development in US. health care-the growth of a proprietary ambulatory care system composed of health maintenance organizations, urgent care centers, ambulatory surgicenters, ambulatory diagnostic centers, large group practices, and other delivery modalities. The growth of this system as a result of the ease of access to capital, limited or nonexistent regulation through Certificate of Need or other mechanisms, the growing surplus of physicians, decreases in the use of hospitals as a result of changed insurance benefits and inpatient utilization review, new developments in biotechnology, and computerization and miniaturization of new technological advances is discussed. The reasons for the expanded growth of proprietary chains over nonprofit systems of ambulatory care are also discussed. The article concludes with a discussion of the negative consequences for individual health and the health care system that may be generated by the continued growth of proprietary ambulatory care.

Political Science Quarterly, 1980

Routledge eBooks, Aug 9, 2022

Routledge eBooks, Jan 16, 2018

Routledge eBooks, Nov 25, 2020

This article examines the reasons why proprietary hospital chains have become interested in buyin... more This article examines the reasons why proprietary hospital chains have become interested in buying or managing academic health center hospitals. Among the explanations that are discussed are such factors as vertical integration of health care, chain legitimation, integration of finance and delivery systems, and short-term profit potential. These factors are further examined through the use of a structured analysis of the interpenetration of proprietary chain hospitals and academic medical centers. We also discuss the consequences of these linkages in terms of such issues as continued educational mission, types of sponsored research programs, degree of indigent care provision, and changes in the nature of physician and other health worker training. The larger social implications of the movement of proprietary chains into tertiary medical care are evaluated. In the mid-1980s there appear to be two overlapping spheres of analysis that have engaged health policy analysts regarding the future of health services organization. These can be summarized as: (a) What form will hospitals and especially teaching hospitals take to survive? and (b) To what extent will multi-institutional chains dominate the national health care market? This paper begins to address the convergence between these two questions by presenting a schematic national overview of simultaneous developments among academic medical center complexes and the major for-profit hospital chains. Through interregional mapping and interpretation of the locations of major teaching hospitals and chain institutions across the United States, we seek to place in a general health systems perspective the dual and potentially convergent national importance of both. After over 15 years of expanding operations as owners and managers of general care hospitals, why should the for-profit sector become interested in the takeover of teaching hospitals? What are the implications-for the health system, for the academic medical centers (AMCs), and for the proprietary chains-of such changes in ownership patterns? The question of why AMCs have agreed to become involved with proprietary companies (such as stated needs for greater access t o capital) has already been studied in detail by others (1-3). Given the general strategic interpretations of the recent corporate restructuring of academic medical centers, including joint ventures with proprietary chains, we focus our attention on the overall behavior of the chains themselves. Of particular interest

International Journal of Epidemiology, Aug 27, 2004

Social Science & Medicine. Part D: Medical Geography, Jun 1, 1979

International Journal of Health Services, Apr 1, 2002

Routledge eBooks, Oct 8, 2021

International Journal of Health Services, Apr 1, 2001

Labor unions that represent health care workers encounter unique circumstances. This study focuse... more Labor unions that represent health care workers encounter unique circumstances. This study focuses on 1199-the largest health care workers' union in the United States, based in New York City-and describes how the union and its National Benefit Fund have structured a managed indemnity health insurance program that provides extensive benefits for its members. The authors detail the workings of the National Benefit Fund and the ways in which it can improve the health care of its members through its union structure. The Fund represents a model for improving the provision of health care to Americans.

International Journal of Health Services, Oct 1, 1987

In this article we examine the previously little-studied development in US. health care-the growt... more In this article we examine the previously little-studied development in US. health care-the growth of a proprietary ambulatory care system composed of health maintenance organizations, urgent care centers, ambulatory surgicenters, ambulatory diagnostic centers, large group practices, and other delivery modalities. The growth of this system as a result of the ease of access to capital, limited or nonexistent regulation through Certificate of Need or other mechanisms, the growing surplus of physicians, decreases in the use of hospitals as a result of changed insurance benefits and inpatient utilization review, new developments in biotechnology, and computerization and miniaturization of new technological advances is discussed. The reasons for the expanded growth of proprietary chains over nonprofit systems of ambulatory care are also discussed. The article concludes with a discussion of the negative consequences for individual health and the health care system that may be generated by the continued growth of proprietary ambulatory care.

Political Science Quarterly, 1980

Routledge eBooks, Aug 9, 2022

Routledge eBooks, Jan 16, 2018

Routledge eBooks, Nov 25, 2020

This article examines the reasons why proprietary hospital chains have become interested in buyin... more This article examines the reasons why proprietary hospital chains have become interested in buying or managing academic health center hospitals. Among the explanations that are discussed are such factors as vertical integration of health care, chain legitimation, integration of finance and delivery systems, and short-term profit potential. These factors are further examined through the use of a structured analysis of the interpenetration of proprietary chain hospitals and academic medical centers. We also discuss the consequences of these linkages in terms of such issues as continued educational mission, types of sponsored research programs, degree of indigent care provision, and changes in the nature of physician and other health worker training. The larger social implications of the movement of proprietary chains into tertiary medical care are evaluated. In the mid-1980s there appear to be two overlapping spheres of analysis that have engaged health policy analysts regarding the future of health services organization. These can be summarized as: (a) What form will hospitals and especially teaching hospitals take to survive? and (b) To what extent will multi-institutional chains dominate the national health care market? This paper begins to address the convergence between these two questions by presenting a schematic national overview of simultaneous developments among academic medical center complexes and the major for-profit hospital chains. Through interregional mapping and interpretation of the locations of major teaching hospitals and chain institutions across the United States, we seek to place in a general health systems perspective the dual and potentially convergent national importance of both. After over 15 years of expanding operations as owners and managers of general care hospitals, why should the for-profit sector become interested in the takeover of teaching hospitals? What are the implications-for the health system, for the academic medical centers (AMCs), and for the proprietary chains-of such changes in ownership patterns? The question of why AMCs have agreed to become involved with proprietary companies (such as stated needs for greater access t o capital) has already been studied in detail by others (1-3). Given the general strategic interpretations of the recent corporate restructuring of academic medical centers, including joint ventures with proprietary chains, we focus our attention on the overall behavior of the chains themselves. Of particular interest

International Journal of Epidemiology, Aug 27, 2004