Managing Managed Care

The managed care industry succeeded in holding down health costs for most of the 1990s. But it now is under unprecedented attack from critics, who charge HMOs and similar plans have seriously compromised the quality of care by excessively focusing on their bottom lines. With public frustration building, the Clinton administration and lawmakers in Congress are proposing a variety of regulatory remedies to rein in the power of health insurers to make critical care decisions. Reform advocates say the proposals would empower consumers and allow doctors to deliver patient care without interference. But managed care advocates contend the proposals would only succeed in driving up the cost of health coverage. The net result, they say, would be more uninsured people and bigger bills for working Americans.