Luft H S
Milbank Mem Fund Q Health Soc. 1980 Fall;58(4):501-36.
HMOs contract to provide physician and hospital services to enrolled populations in return for fixed periodic payments. Total costs for HMO members are shown to be lower than for those enrolled in conventional insurance plans. But the explanation for this and related differences cannot be attributed solely to matters of efficiency, quality, or even consumer self-selection or physician satisfaction. Although public policy assumes that HMOs will encourage beneficial competitive responses by traditional health care providers, too little is known to predict the nature and extent of such probabilities.
健康维护组织（HMOs）签订合同，为参保人群提供医生和医院服务，以换取定期定额付款。事实表明，HMO成员的总成本低于参加传统保险计划的成员。但对此以及相关差异的解释不能仅仅归因于效率、质量问题，甚至不能仅仅归因于消费者的自我选择或医生的满意度。尽管公共政策假定HMOs将鼓励传统医疗服务提供者做出有益的竞争反应，但对于这种可能性的性质和程度，我们所知甚少，难以做出预测。
