The confluence of two important trends—the dramatic growth of managed care and the impending oversupply of physician specialists—is examined by Weiner1 in this issue of The JOURNAL. Enrollment in managed care plans has increased from 12.5 million persons in 1983 to 45 million in 1993.2,3 This growth will almost certainly continue whether or not the Clinton Health Security Act—or some variant—is enacted, because both the business sector and most state governments believe managed care is less expensive than traditional feefor-service medicine.
See also p 222.
Though "managed care" is now a familiar term, it embraces a widely diverse set of organizational and financing arrangements, including such tightly run group practice health maintenance organizations (HMOs) as Kaiser Permanente, looser affiliations of physicians and hospitals that are linked by marketing and payment formulas, and traditional forms of practice that are "managed" by a corporate third party that attempts to restrain
Schroeder SA. The Latest ForecastManaged Care Collides With Physician Supply. JAMA. 1994;272(3):239-240. doi:10.1001/jama.1994.03520030081034