Managed Care and Insurance Companies.html

Managed Care and Insurance Companies

True access to patient care is controlled by corporations—namely, managed care organizations and indemnifiers, corporations that conduct business based on profit margins and cost reduction without knowledge of medical practice.

As a result, the healthcare consumer must select from a panel of approved doctors, hospitals, outpatient facilities, allied health professionals, and pharmaceutical programs. If the consumer does not accept these restrictions, they must pay large out-of-pocket expenses.

While we are spending more and more of our income on healthcare products, we continue to give up more and more control over its quality and management. More concerning is the trend of nonmedical personnel making critical day-to-day decisions regarding access to care.

As we wait and see the final outcome of the Affordable Care Act legal challenge, which would move most people into a managed care system, we may give up even more access as new layers of government bureaucracy are put into place.

This last video lecture leads you to a deeper understanding of managed care. This topic is complex and takes many facets in the healthcare systems. Read the following resource for a deeper understanding of this material.

Resource:

Baldor, R. A., & NetLibrary, I. (1998). Managed care made simple (2nd ed.). Malden, Mass: Blackwell Science. Retrieved from: http://web.a.ebscohost.com.southuniversity.libproxy.edmc.edu/ehost/detail/detail?sid=78109f3e-3659-4151-a0a6-2fae3b518578%40sessionmgr4010&vid=0&hid=4104&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=52327&db=nlebk .

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