By Arnold Birenbaum
This book focuses on how a distinctly American product--managed care--got its start, how it works, and what needs to be adjusted in the future. As Birenbaum makes clear, this book is about social change. It is about doctors contracting with health maintenance organizations (HMOs) and being subject to their rules; about the limited access to specialty care; and about the frugal use of hospital admissions and stays. Consumers and providers have had mixed experiences in these health-delivery systems. Birenbaum, a health-policy analyst, has created a synthesis of research studies and analyses of trends to chronicle these developments and to suggest remedies to correct the most unjust aspects of managed care.