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June 25, 1997

Is Managed Care Really Here to Stay?

Author Affiliations

Willingboro, NJ

JAMA. 1997;277(24):1934. doi:10.1001/jama.1997.03540480034032

To the Editor.  —Changes sweeping over medicine involve more the business of delivery than the science of medicine. In his Commentary1 on managed care, Dr Fuchs1 underlined concerns that "social gains from greater efficiency" are but a "transfer from one set of pockets to another."I agree with Fuchs that managed care is here to stay, but I disagree with his first of 3 statements on public policy; ie, "only the government can create a system to co ver the uninsured." To prevent the need of state or federal governments to create a tax burden to subsidize health care for the uninsured, health insurance companies should be required to cover a predetermined number of screened, uninsured individuals as part of their obligation of licensure.Managed care companies should take the initiative and prevent legislatures from having to act in the public interest. Changes in the health care system