The Exportation of Managed Care to Latin America

While concern about the direction of managed care has intensified in the United States,1 managed care has been diffusing rapidly to other countries. During the late 1980s and early 1990s, reforms in several European national health programs introduced principles of managed care, market competition, and privatization of public services.13 More recently, managed-care reforms in some European countries, including the United Kingdom, the Netherlands, and Sweden, have been reversed.35 Since the mid-1990s, U.S. managed-care organizations and investment funds have rapidly entered the Latin American market. The exportation of managed care has been linked to privatization and cutbacks in public-sector . . .