I was invited by a small group of medical students to speak to them about “managed care.” This group of students meets regularly for discussions of general topics. They kept hearing about managed care and about health care reform, and they felt like they didn’t understand any of it.
I hope I didn’t commit a sin talking to naïve medical students about the business of medicine so early in their training. This is normally a time that their heads are stuffed with facts about biochemistry, physiology, pathology and microbiology, not practical stuff like the vagaries of our insurance system.
The students had identified a very nice article about managed care and its many variations for us to discuss (Sekhri NK. Managed care: the US experience. Bull World Health Organ. 2000;78(6):830-44). My favorite line in that paper was ‘‘if you have seen one managed care plan, you have seen one managed care.” The complications of the payment systems for health care are extraordinary.
With the people of Massachusetts sounding a resounding “No!” for the current health care reform plans, it’s clear something different, something for which there is greater consensus, is needed.