The Delegated Welfare State Medicare, Markets, and the Governance of Social Policy

InThe Delegated Welfare State, the first book in theOxford Studies in Postwar American Political Developmentseries, Andrea Campbell and Kimberly Morgan tackle the federal government's increasing propensity in recent times to outsource governmental functions to the private sector. They use the Medicare Modernization Act of 2003, under which insurance companies assumed many policy implementation responsibilities, as their central example, but their argument extends far beyond that single episode. They also consider the government's reliance on private security forces in Iraq, its use of for-profit entities to provide social services, and its outsourcing of construction oversight in federal disaster zones to private companies. The book's primary aim is to show how 'delegated governance' works as a method to overcome opposition to expanded government intervention by awarding private interests a stake in public programs. The authors' show that it is not just conservatives who favor the approach. Liberals rely on it as well in order to build broad political coalitions around social programs (and to avoid the charge of big-government liberalism). Despite the approach's popularity, they contend that there are significant long-term costs. Delegated governance hampers the growth of state capacity, increases the power of private interests in policymaking, and reinforces public cynicism about public sector corruption and favoritism. The Bush administration certainly accelerated the shift toward delegated governance, but the impulse precedes that administration and will surely impact policymaking in the Obama administration. This book explains what delegated governance is, how it works, and the significant costs that it exacts on the American polity.

KIMBERLY J. MORGAN is Associate Professor of Political Science at George Washington University. ANDREA LOUISE CAMPBELL is Associate Professor of Political Science at the Massachusetts Institute of Technology.