The Delegated Welfare State: Medicare, Markets, and the Governance of Social Policy (Studies in Postwar American Political Development)

Why are so many American social programs delegated to private actors? And what are the consequences for efficiency, accountability, and the well-being of beneficiaries? __The Delegated Welfare State__ examines the development of the American welfare state through the lens of delegation: how policymakers have avoided direct governmental provision of benefits and services, turning to non-state actors for the governance of social programs. Utilizing case studies of Medicare and the 2009-10 health care reform, Morgan and Campbell argue that the prevalence of delegated governance reflects the powerful role of interest groups in American politics, the dominance of Congress in social policymaking, and deep contradictions in American public opinion. Americans want both social programs and small government, leaving policy makers in a bind. Contracting out public programs to non-state actors masks the role of the state and enlists private allies who push for passage. Although delegated governance has been politically expedient, enabling the growth of government programs in an anti-government political climate, it raises questions about fraud, abuse, administrative effectiveness, and accountability. In probing both the causes and consequences of delegated governance, __The Delegated Welfare State__ offers a novel interpretation of both American social welfare politics and the nature of the American state. Why are so many American social programs delegated to private actors? And what are the consequences for efficiency, accountability, and the well-being of beneficiaries? The Delegated Welfare State examines the development of the American welfare state through the lens of delegation: how policymakers have avoided direct governmental provision of benefits and services, turning to non-state actors for the governance of social programs. Utilizing case studies of Medicare and the 2009-10 health care reform, Morgan and Campbell argues that the prevalence of delegated governance reflects the powerful role of interest groups in American politics, the dominance of Congress in social policymaking, and deep contradictions in American public opinion. Americans want both social programs and small government, leaving policy makers is a bind. Contracting out public programs to non-state actors masks the role of the state and enlists private allies who push for passage. Although delegated governance has been politically expedient, enabling the growth of government programs in an anti-government political climate, it raises questions about fraud, abuse, administrative effectiveness, and accountability. In probing both the causes and consequences of delegated governance, The Delegated Welfare State offers a novel interpretation of both American social welfare politics and the nature of the American state. Book jacket 'the Delegated Welfare State' Tackles The Federal Government's Increasing Propensity In Recent Times To Outsource Governmental Functions To The Private Sector. Introduction -- Exploring The Delegated Welfare State -- Medicare And The Delegated Welfare State In The Post-war Era -- The Rise Of The Market Reform Movement -- Crafting The Medicare Modernization Act Of 2003 -- Administering The Delegated Welfare State The Cases Of Medicare And The Medicare Modernization Act -- The Delegated Welfare State And Policy Feedbacks -- Citizens, Consumers, And The Market Model. Kimberly J. Morgan And Andrea Louise Campbell. Includes Bibliographical References And Index. In The Delegated Welfare State, the first book in the Oxford Studies in Postwar American Political Development series, Andrea Campbell and Kimberly Morgan use the exampke of Medicare to tackle the federal government's increasing propensity in recent times to outsource governmental functions to the private sector.