Reed Marie C, Trude Sally
Track Rep. 2002 Aug(3):1-4.
A turbulent backlash against managed care in the mid-1990s pitted consumers and health care providers against health plans in a struggle for control over medical decision making. New findings from the Center for Studying Health System Change (HSC) Community Tracking Study Household Survey indicate consumer confidence in the system and trust in physicians increased slightly between 1997 and 2001, perhaps as a result of changes in laws and loosening of health plan restrictions. Nevertheless, there is strong evidence of continued public concern about the influence of health plans on medical decision making. For example, the level of trust in their physicians among people in fair or poor health has not increased, and more than 40 percent of privately insured Americans continue to believe their doctor is strongly influenced by health plan rules when deciding about their care.
20世纪90年代中期,针对管理式医疗的激烈强烈反对,使消费者和医疗服务提供者与健康计划展开了一场争夺医疗决策控制权的斗争。医疗体系变革研究中心(HSC)社区追踪研究家庭调查的新发现表明,1997年至2001年间,消费者对该体系的信心以及对医生的信任略有增加,这可能是法律变化和健康计划限制放宽的结果。然而,有充分证据表明,公众仍对健康计划对医疗决策的影响深感担忧。例如,健康状况一般或较差的人群对医生的信任程度并未提高,超过40%的美国私人保险参保者仍然认为,他们的医生在决定其治疗方案时受到健康计划规则的强烈影响。