ABSTRACT
This chapter provides an overview and critique of perspectives constituting the globalization debate. Following from the critique, Marxian and world historical approaches to global economic restructuring are presented, laying bare the methodological basis for this study. It demonstrates that a major cause of cost escalation in US health care has been the monopoly structure of production of medical technology. The chapter explores the paper traces the response of US hospitals to cost escalation. The US instance therefore serves as a starting point for analyzing the global integration of nursing labor markets, a topic that is undertheorized in the traditions of Marxian economics and world historical analysis. Analyzing the health-insurance industry-commonly cited as primary force in escalating US health-care costs-Newhouse argues that insurance companies in the early were themselves attempting to deal with unbridled rising costs, as were managed-care companies shortly thereafter. The notion of "economies of scale" is used as justification for "technical monopoly" in the production of health care.
