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January 23, 1995

Managed Care and Managed Death

Author Affiliations

Division of General Internal Medicine and Center for Clinical Bioethics Georgetown University Medical Center Washington, DC 20007

Arch Intern Med. 1995;155(2):133-136. doi:10.1001/archinte.1995.00430020016003

Two STRONG movements have each begun to enlist many enthusiastic adherents throughout the nation: a movement toward managed care as a means of cost control and a movement toward managed death through euthanasia and assisted suicide. Both movements have been controversial. But while each has been discussed separately, little attention has been given to whether the temporal convergence of these movements has any bearing on sound public policy making. It is also appropriate to ask whether these movements share anything in common besides their names and the controversy that surrounds them.

MANAGED COMPETITION AND MANAGED CARE  Currently, more than 13% of the American gross national product is derived from health care.1 It is widely believed that this amount of health care expenditure is excessive and must be controlled.There are many proposals to try to fix the health care system. For a variety of reasons, not convincing to all,