Managed health-care: managing demand through the control of supply.

Managed Care has been developed in the United States as a strategy over the failure of the insurance system in controlling costs and utilisation. It works through a model which incorporates financing and delivery of services, with the control of health-care providers, facilities and services, as well as programmes like quality assurance and utilisation review, to achieve its goal of providing adequate care at an affordable price. In economic terms, that is to manage demand through the control of supply. In Singapore, the National Trade Union Congress (NTUC) has launched the pilot large-scale managed care plan in 1994. It is not recommended in this article that the entire managed care model be transplanted into Singapore, but some of the principles could be used to improve our healthcare system. Applicability of the managed care concept must be viewed with the peculiar health system in Singapore such as the already existing low-cost and easily accessible primary care service. More time would also be required to prepare the health-care professionals as well as the public for this new health-care venture.