Must Good HMOs Go Bad? First of Two Parts: The Commercialization of Prepaid Group Health Care

Abstract

...In sum, although nonprofit status seems to be conducive to a less harsh form of managed care, it is no guarantee. The relentless pressure to cut costs will undoubtedly continue. The key question is whether counter-pressures will provide adequate checks and balances. In principle, counter-pressures can be generated by informed consumers with a meaningful choice of competing plans, professional ethics, the quality movement, industry self-regulation, and the growing bipartisan drive for government regulation. I will address these issues in Part 2 of this report.