Managed Care


Free Market or Mandate? (Whom Do You Trust?)

MANAGED CARE May 1998. © MediMedia USA
Editor's Memo

Free Market or Mandate? (Whom Do You Trust?)

John A. Marcille
MANAGED CARE May 1998. ©1998 Stezzi Communications

John A. Marcille

So much happens at each National Managed Health Care Congress that it is impossible to distill the experience. Thousands of physicians, pharmacists and other professionals, plus hundreds of vendors, converged on Atlanta last month. Still, some things stand out.

At the the policy level, there was concern for structural and political issues, the former exemplified by Harvard Professor Regina Herzlinger's keynote talk on market-driven health care. As it happens, Senior Contributing Editor Patrick Mullen interviewed her just a week before the conference, and you can read the transcript, starting on page 40.

Former New York Gov. Mario Cuomo, a Democrat, in a debate with a potential GOP presidential candidate, former U.S. Rep. Jack Kemp, also of New York, warned against trusting entrepreneurs to structure a health care system that will ensure availability of care for the growing ranks of the uninsured, though he did argue, "If you can do it privately, that's the first choice." Kemp spoke for tax credits or vouchers for the unemployed uninsured and tax deductions for the employed uninsured (Cuomo: deductions are wrong because they favor the wealthy)."There should be a direct subsidy to the poor," Kemp said, observing, "Even my party has gone to extremes" in addressing the problem. Notably, they agreed that definitive action on this issue and most of the many managed care regulations proposed in Washington is unlikely this year.

So much for policy. At the nitty-gritty level, there was a lot of attention to legal liability — providers have it; health plans may have to confront it — as well as disease management successes (finally being documented) and the newer kinds of managed care organizations, such as provider-sponsored organizations and integrated systems. The ideas batted around, no less than the web of contacts and alliances made by the thousands of participants, will surely affect the development of health care.


4th Partnering With ACOs Summit Los Angeles, CA October 27–28, 2014
PCMH & Shared Savings ACO Leadership Summit Nashville, TN November 3–4, 2014
2014 Annual HEDIS® and Star Ratings Symposium Nashville, TN November 3–4, 2014
Medicare Risk Adjustment, Revenue Management, & Star Ratings Fort Lauderdale, FL November 12–14, 2014
World Orphan Drug Congress Europe 2014 Brussels, Belgium November 12–14, 2014
Healthcare Chief Medical Officer Forum Alexandria, VA November 13–14, 2014
Home Care Leadership Summit Atlanta, GA November 17–18, 2014
HealthIMPACT Southeast Tampa, FL January 23, 2015