Description
Managed care is not a new model of health insurance in the United States. In the late nineteenth century, some doctors served as prepaid providers, treating company employees in exchange for a set fee. Yet it was not until the 1980s that managed-care plans emerged in the mainstream, enlisting employers and politicians with promises of lower health-care costs and more-coordinated care. In the fourth e-seminar in his series The Politics of Health Care, Michael S. Sparer, associate professor of public health at Columbia University's Mailman School of Public Health, discusses the rise of health-maintenance organizations (HMOs) and other forms of managed care. He reveals the legislative underpinning of managed-care plans and why physicians and health-care consumers have long resisted them. Finally, he explains how efforts by insurers and policymakers to respond to the ongoing managed-care backlash are undermining the ability of managed-care plans to deliver on their initial promises.



Professor Sparer discusses the case of David Goodrich, a California prosecutor who died from stomach cancer in 1995 after his managed-care plan delayed approval for a recommended bone-marrow transplant.