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Managed care under siege.

R A Epstein1

  • 1University of Chicago, Illinois, USA.

The Journal of Medicine and Philosophy
|December 30, 1999
PubMed
Summary
This summary is machine-generated.

Managed Care Organizations (MCOs) face criticism, but private healthcare evolution, without heavy regulation, is more effective for cost containment and access. Excessive regulation risks market failure and greater government control.

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Area of Science:

  • Health Policy
  • Healthcare Management
  • Health Economics

Background:

  • Managed Care Organizations (MCOs) are often criticized for marketing errors.
  • Criticism frequently uses an idealized benchmark of competitive markets or government provision.
  • Accurate assessment requires comparing error rates in healthcare provision.

Purpose of the Study:

  • To evaluate the effectiveness of Managed Care Organizations (MCOs) in healthcare delivery.
  • To compare private healthcare mechanisms with government regulation.
  • To analyze the impact of proposed regulatory fixes on MCOs.

Main Methods:

  • Comparative analysis of error rates in healthcare provision.
  • Assessment of private healthcare mechanisms versus government regulation.
Keywords:
Analytical ApproachHealth Care and Public Health

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  • Evaluation of proposed regulatory interventions for MCOs.

    • Main Results:

    • Healthcare provision has inherently high error rates due to uncertainties in cost and treatment effectiveness.
    • Private healthcare mechanisms, evolving rapidly without regulation, are more likely to secure access and contain costs.
    • State regulation poses risks of capture and inefficient, monopolistic behavior.

    Conclusions:

    • Proposed fixes for MCOs (e.g., specialist access, out-of-network care) may increase costs without commensurate value.
    • Over-regulation risks market failure, potentially leading to greater losses under government control of healthcare.
    • The evolution of private healthcare offers a more promising path for access and cost containment than government intervention.