Managed Care Essay -- Healthcare Health Medical Essays

Managed Care   Ã‚  Ã‚  Ã‚  Ã‚  There are so many problems with our society’s health care. Everyone wants to find a solution, but no one has been able to come up with one yet. Many different things have been tried, but none have put a cease to the exorbitant costs, which most believe to be the main problem. Out of everything tried, the most recent and popular system is known as managed care. Managed care is the most common form of health insurance in the United States, and provides more a cost efficient coverage than paying a fee-for-service charge. However, it is also a very complicated system. Over the next few pages I am going to try and go over the main parts of the managed care structure. In the end, I am going to decide the strengths and weaknesses of this system, and decide whether or not I think it will be the answer to our system.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  First I am going to go over exactly what managed care means, as simply as possible. Managed care is an organized approach to delivering a comprehensive array of health care services to a group of enrolled members through efficient management of services needed by the members, and negotiation of prices or payment arrangements with providers. It has two main functions; first it integrates the functions of financing, insurance, delivery, and payment with one organizational setting, and it also exercises formal control over utilization.   Ã‚  Ã‚  Ã‚  Ã‚  Now I am briefly going to go over the history of managed care. Managed care dates back to as early as 1882. Northern Pacific Railroad Beneficial Association was one of the first employers to offer health care coverage. In 1910, the Western Clinic in Tacoma, Washington offered medical services through its providers for a premium of only $.50 per month, which served lumber mill owners and employees. In 1929, Blue Cross was originated when Baylor Hospital in Texas agreed to provide coverage by the case on a prepaid basis for some 1,500 teachers. The Kaiser Foundation Health Plan was started in 1937 as well. In 1971, the Nixon Administration announced a new national health strategy, which was the development of health maintenance organizations. The federal government established grant and loan guarantees for HMO’s to reach a goal from 30 in 1970 to 1,700 by 1976, enrolling 40 million people, and 90... ... insurance. Also, MCO’s favor preventative care and health promotion. Many people feel that if you get to the root of the problem, it will help our financial health costs, and managed care provides help for this.   Ã‚  Ã‚  Ã‚  Ã‚  Some of the negative things I feel about managed care is there is somewhat of a public dissatisfaction. As I said before, everyone wants the system to change and be better, but no one knows how to do it. Another negative thing about it is there are many limitations on what doctors you can see, and the ease of seeing a secondary doctor. There is also the issue of rising prescription drug costs that managed care does not address.   Ã‚  Ã‚  Ã‚  Ã‚  All in all I think that even though managed care is not perfect, it is the best that we have right now. It has done a good job of controlling costs, and keeping individuals out-of-pockets costs down. Until something better comes along, I think people need to realize that we are doing the best with what we have, and try to be more accepting and understanding. Americans have made health care the way it is today, so they need to understand big problems like this can’t be changed overnight.