THE BROAD and increasing public interest in the quality of care follows in the wake of a vigorous national movement by federal and state government, as well as employers, to enroll the US population in managed care plans. The major impetus for the movement was cost containment, supported by the performance of several long-established health maintenance organizations; this limited experience was extrapolated to an assumption that any or all managed care companies, while cutting costs and utilization of health services but exercising prevention, would improve access to health care that was the equal to or better than that provided in a fee-for-service system.
Having incorporated managed care plans as a permanent fixture in the US health care system, questions have now arisen about their long-term ability to control costs and subscribers' tolerance to cost-cutting measures. Concurrent with managed care's impressive growth, the problem of the number of Americans without health care insurance
Johnson MT. Ensuring Quality of Dermatologic Care in the US Health Care System. Arch Dermatol. 1997;133(11):1355-1357. doi:10.1001/archderm.1997.03890470027005