The Managed Care Blues and How to Cure Them

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240 pp., 6 x 9
Paperback
ISBN: 9780878406807 (0878406808)


September 1998
LC: 98-16018

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The Managed Care Blues and How to Cure Them
Walter A. Zelman and Robert A. Berenson

Shattering the myths about what's wrong with managed health care, this penetrating introduction to managed care explains its origins and identifies its real achievements and shortcomings.

Walter A. Zelman and Robert A. Berenson argue that many criticisms of managed care tend to idealize the costly and fragmented insurance system it supplanted, without pinpointing the true inadequacies of today's managed care. In addition to providing reasoned answers to the most alarmist critiques of managed care, the authors maintain that it has not fulfilled its potential to improve the overall quality of care.

The authors propose thirteen concrete recommendations for raising quality in managed care programs, ranging from enacting additional legal protections and increased disclosure to putting the purchasing power in the hands of those who care most about quality — individuals, rather than employers.

With practical solutions for making managed care better, The Managed Care Blues and How to Cure Them is a bold call for greater consumer protection, knowledge, and power in the health care arena.


Walter A. Zelman is an instructor in health policy and management at the School of Public Health at Harvard University. He has served as a special deputy to the commissioner of the California Department of Insurance and as the California director of Common Cause, the public interest group.

Robert A. Berenson, MD, is currently director of the Center for Health Policy Plus and Providers in the Health Care Financing Administration, Department of Health and Human Services. He has practiced medicine for more than twenty years and was the founder and medical director of the National Capital Preferred Provider Organization.

Both authors have served as health policy advisors to the White House.


Reviews
"Timely . . . presents a well balanced review of the managed health care world as it actually exists. . . . provides a fine resource for those who genuinely want, or need, to take a balanced review of managed health care . . . The authors provide a worthy service in elucidating, as clearly and articulately as one might hope, a fair discussion of issues in the industry."—Healthplan



"At long last, an honest, frank appraisal of managed care, by two of the nation's most respected policy analysts. A must read for anyone concerned about these critical issues."—Philip R. Lee, MD, former Secretary of Health and professor emeritus, School of Medicine, University of California, San Francisco



"Zelman and Berenson have written one of the most important health policy books of the decade. It identifies the phony managed care issues—false consumerism and hysteria over anecdotes and then moves on to the true issues—its failure to fulfill its potential to improve quality of care and to build a system of evidenced-based care. Their ability to explain the complex simply makes the reading a pleasure."—Jon Gabel, director, Center for Survey Research, KPMG Peat Marwick, LLP



"A provocative account of where our health care system is, where it was, and where it is going. It broadens the debate and raises compelling questions for all stakeholders."—Karen Ignagni, president, American Association of Health Plans