From managed care to "financed care"

Paying for health care in the new millennium may require fundamental restructuring of how costs are managed to avoid rationing and a government takeover.     

Competition and physician-enabled demand: The role of managed care

Recent organizational changes in the health care sector promote greater patient participation in their treatment decisions. How physicians respond to patient-initiated requests for treatment is an issue of considerable policy interest. To study this phenomenon, we introduce the notion of physician-enabled demand and examine empirically whether this behavior responds to competitive pressures in the market and financial incentives associated with different physician payment mechanisms.We find that physician-enabled demand increases with more competition under fee-for-service reimbursement, but decreases with greater competition under managed care. This asymmetric response is quite consistent with our conceptual framework and at odds with alternative interpretations.     

Why managed care has gone too far

Managed care has not solved employers' problems with rising health care costs; instead, it has created another set of problems, this author maintains. She suggests steps that employers can take to enhance the quality of health care for their employees and prevent further damage from the excesses of managed care.