Regulating Managed Care: Theory, Practice, and Future Options

By Stuart H. Altman; Uwe E. Reinhardt et al. | Go to book overview
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genuine consumer participation in regulatory proceedings of insurance regulators may be another avenue to explore.

Indeed, such initiatives—often advocated by the most progressive forces—dovetail with the market-based strategies of those who prefer conservative approaches to regulation and policy in general.

Finding Common Ground

Advocates of direct and market-based intervention may wish to search for common ground. Demands imposed on health plans to protect consumers will have very limited capacity to secure and raise quality if the first priority of the marketplace is lower price. Thus marketplace forces and purchasing issues must be addressed. Still, even the boldest of market-oriented interventions will not likely address all of the concerns of individual patients in managed care plans.

The search for common ground might begin with a conscious focus on the ends rather than the means. Both those who tend to accept more government intervention and those who lean against it need to consider whether some of the strategies and means of the other might be necessary and appropriate to achieve the ends they hold dear. Government intervention is but a means. Traditional ideological inclinations to support or oppose it should remain secondary to the goals being sought.

Some of these circumstances are discussed in a 1979 law review article by Robert Reich. (Reich, R. B. “Toward a New Consumer Protection.” University of Pennsylvania Law Review, 1979, 128). They are listed here in a somewhat altered and less theoretical form.
Surveys vary depending largely on how the question is asked and how the choice is defined.
Miller, R. H., and Luft, H. S. “Does Managed Care Lead to Better or Worse Quality of Care?” Health Affairs, Sept.–Oct. 1997, pp. 7–25.
Gabel, J. R., Ginsburg, P. B., and Hunt, K. A. Health Affairs, Sept.–Oct. 1997, p. 107.
For a fuller discussion of these and related consumer protection options see Rodwin, M. A. “Consumer Protection and Managed Care, Houston Law Review, 1996, 32.


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