Coppola M N, Croft T, Leo E
Office of Managed Care, U.S. Army, Falls Church, VA 22041, USA.
Med Group Manage J. 1997 Sep-Oct;44(5):72, 74, 76-82 passim.
As we approach 2000, health care cost, quality and access continue to be highly debated issues within managed care and the health care delivery system. Of these, perhaps there is no single issue more contested among consumers than the average cost of health care. Factors affecting the cost of health care are many. However, the uninsured population is one of the most visible and difficult to predict. Leaders in managed care have extensively studied this problem for several years; however, there continues to be no consensus on the best way to capture the nearly 42 million uninsured, reprogram scarce health care resources or provide access into the health care delivery system for everyone while maintaining existing quality, cost containment measures and administration. This paper outlines the scope and impact of the uninsured in managed care and profiles initiatives in controlling the population.
随着我们迈向2000年，医疗保健成本、质量和可及性仍然是管理式医疗和医疗保健提供系统中备受激烈争论的问题。在这些问题中，或许没有哪个单一问题比医疗保健的平均成本在消费者中更具争议性。影响医疗保健成本的因素众多。然而，未参保人群是最明显且最难预测的因素之一。管理式医疗领域的领导者们已经对这个问题进行了数年的广泛研究；然而，对于如何接纳近4200万未参保者、重新规划稀缺的医疗保健资源，或者在维持现有质量、成本控制措施及管理的同时让每个人都能进入医疗保健提供系统，仍然没有达成共识。本文概述了未参保人群在管理式医疗中的范围和影响，并介绍了控制这一人群的举措。
