Managed Care and Physicians

Paper Summary:

Many physicians agree that managed care is not doing the job it was originally created to do. This paper shows that, although reform efforts have not worked in the past, many doctors believe now is the time to revisit reform to combat the lack of health care access to a growing number of Americans, escalating costs, and deteriorating quality. This paper explores the evolution of managed care, and its problems and possible solutions from the viewpoint of two organizations representing the interests of physicians.

From the Paper:

"In 1993, President Clinton introduced a plan for regulated health care reform in response to escalating costs and the growing ranks of the uninsured. From 1970 until the time of the reform proposal, health care spending had increased from $74.4 billion to $752 billion annually. The Clinton proposal was met with huge opposition from the "medical industrial complex" comprised of insurance firms, pharmaceutical companies, hospital suppliers and medical device companies and from the public who had been led to believe that the plan would give the average American less choices and higher costs. After the plan was rejected, Americans turned to managed care to control health care costs, to improve the quality of care, and to preserve their choice of provider and insurance plan. By 1999, ninety-one percent of all employees with health insurance were enrolled in managed care programs ranging from Health Maintenance Organizations (HMOs) that require enrollees to select from a network of doctors, to Preferred Provider Organizations (PPOs) that provide more flexibility in doctor selection at a higher cost than HMOs."

More papers on Managed Care and Physicians:

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• Research Paper # 66472 : "Understanding the Managed Care System"

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