Managed Care — A Look Back and a Look Ahead

Americans are not inclined to spend much time or effort assessing the past; directing their energies to shaping the future, they believe, will result in much larger benefits. But it can be argued that underinvestment in assessing the past is likely to lead to faulty estimates and erroneous prescriptions for future action.Consider the history of managed care. Initial legislation by Congress in late 1973 to provide federal funding for the expansion of health maintenance organizations (HMOs) and HMO enrollment failed to achieve its goal for a variety of reasons, not least among them the inhibitory effects of excessive administrative . . .