Summary |
The role of government in healthcare reform has shifted dramatically with the arrival of managed care, from a healthcare system dominated by government rules, regulations, legislation, and payment practices to a system dominated by market forces. Government continues to operate the Medicare and Medicaid programs that have a major impact on the system, but the strategy for both programs is to enroll their beneficiaries in managed care plans. The primary role for government currently is to intervene when market forces are not working properly and to set standards to which all health plans must comply.
Managed care is a work in progress with much to be done if it is to achieve its advocates’ stated goals. The missing links are a shared vision for the kind of healthcare system that should be established in this country and a leadership plan to get there. The most pressing problem is to find a solution for providing health insurance to all of our citizens. Finally, if we are truly going to mange healthcare, we must begin building healthier communities and start solving many of our social problems to keep them from ending up in hospital emergency rooms.
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