Managed care and managed competition: a primer for social work.

Health and Social WorkVol. 18 Nbr. 2, May 1993

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National Health Line

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Managed care and managed competition: a primer for social work.

National health care reform has been making front-page news since I began writing this column in 1991. President Clinton has touted this reform as the most important domestic issue to be tackled as part of his economic agenda to cut the deficit and stimulate productivity. By the time this column appears, a formal proposal by the Clinton administration will be presented to Congress under the leadership of First Lady Hillary Rodham Clinton (Toner, 1993). The administration is considering managed-competition models, and two single-payer bills, the National Health Security Act and the National Health Care Act, are also on the drawing board this spring.

This column discusses the complex world of managed care and managed competition, separate but related structures for financing and delivering health and mental health care. Because the terms mean different things to different constituencies, it is difficult to analyze and compare models. It is important in upcoming debates on any health care plan to keep a broad perspect...

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