Paley W D
Community Health Plan, Latham, NY 12110.
Psychiatr Q. 1993 Spring;64(1):5-12. doi: 10.1007/BF01071835.
This article provides a short historical review of the HMO movement to set the stage for current HMO developments. It notes the underlying causes of the proliferation of HMO managed care models. It defines what should be the rudiments of a quality HMO program and how the changing societal environment will bring new pressures to bear on HMO programs of the future. As related to the future, the author outlines a direction for national health care reforms. The article concludes that the health care emphasis of the 90s should be in returning some of the responsibility of health care to individual Americans through self-care programs that focus on behavioral change, in turn, leading to healthier Americans, the keys to containing out of control health care costs.
本文对健康维护组织（HMO）运动进行了简短的历史回顾，为当前HMO的发展奠定基础。它指出了HMO管理式医疗模式扩散的潜在原因。它定义了优质HMO计划的基本要素，以及不断变化的社会环境将如何给未来的HMO计划带来新的压力。关于未来，作者概述了国家医疗改革的方向。文章得出结论，20世纪90年代医疗保健的重点应该是通过关注行为改变的自我保健计划，将部分医疗保健责任返还给美国个人，进而造就更健康的美国人，这是控制失控的医疗保健成本的关键。
