The purpose of the third section in this collection is to provide a variety of perspectives on regulation from some of the major stakeholders inside and outside the health care industry. The first stakeholder we hear from is the consumer, as Robert Blendon and his colleagues report on the sources of the managed care backlash. Their research reveals that managed care enrollees are less satisfied with their health coverage than those enrolled in fee-for-service plans. They also conclude that media reports of threatening but rare medical events involving denial of care or catastrophic errors have raised the public's anxiety about managed care.
Karen Davis, the president of the Commonwealth Fund and a longtime health care advocate, writes with David Sandman about the need to ensure quality through regulation. The authors commend the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry that produced the Consumer Bill of Rights and Responsibilities (CBRR), and they recommend many of its provisions. Emphasizing the importance of adequate insurance coverage, choice of health plan, disclosure of information, and rights of grievance and appeal, they contend that these regulations should be adopted at the national level. Davis and Sandman also recommend adoption of the commission's recommendations for the establishment of a quality advisory council, possibly similar to the Medical Payment Advisory Commission (MedPAC), and a private, independent forum for the establishment of national quality standards.