Managed Care

More than 50 million workers - 70 percent of the nation's eligible employees - now have health coverage through managed care. The rapid rise of managed-care firms reflects employers' efforts to reduce their expenses for workers' health benefits. But consumer groups worry that concern about costs will drive medical decisions in huge for-profit firms. And physicians' groups see the focus on cost as antithetical to professional ethics. The managed-care industry asserts that health care will improve under its cost-conscious custody. Health-care firms say they have a financial stake in intervening early and making sure patients get better, not sicker. But seriously ill patients, who are the most expensive gambles for cost-conscious plans, will lose out in the process, some experts predict.