van Amerongen D
Anthem Blue Cross and Blue Shield, Mason, OH, USA.
Physician Exec. 1997 May-Jun;23(5):32-4.
At first glance, it may appear as if managed care itself may be doomed. The avalanche of bills, measures, initiatives, Federal regulations, etc., seemed overwhelming in late 1996. Did this, in fact, portend a national shift away from managed care? What does the consumer protection and regulatory activity really mean? What directions for the future can be identified? This article seeks to answer those questions and highlights a case study of "reform gone awry" that may hold lessons for the national scene. The anti-HMO legislation activity does not represent a repudiation of managed care. Rather, it may be seen as a maturing of the entire process of redefining our medical delivery and financing system.
乍一看，管理式医疗似乎自身难保。1996年末，大量的法案、措施、倡议、联邦法规等纷至沓来，令人应接不暇。这是否真的预示着全国范围内将不再采用管理式医疗？消费者保护和监管活动究竟意味着什么？未来的发展方向又是什么？本文旨在回答这些问题，并着重介绍一个“改革失败”的案例研究，或许能为全国提供借鉴。反健康维护组织（HMO）的立法活动并不意味着对管理式医疗的否定。相反，它可被视为重新定义我们的医疗服务和融资体系这一整个过程的成熟。
