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Understanding The Managed Care Backlash

Published on Jul 1, 1998in Health Affairs5.71
· DOI :10.1377/hlthaff.17.4.80
Robert J. Blendon46
Estimated H-index: 46
,
Mollyann Brodie20
Estimated H-index: 20
+ 4 AuthorsLarry Hugick3
Estimated H-index: 3
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Abstract
PROLOGUE: Managed care has been described with terms as forceful as “revolution.” Given the sweeping implications of such a word, a negative reaction is inevitable on the part of persons and institutions that are affected. For managed care, the “backlash” has taken the form of legislation introduced in nearly every state (more than one thousand bills at last count), aimed at calming consumers' fears of losing control of their health care while trying to retain some of the cost-saving, market-innovating features that managed care has brought to the U.S. health care system. Robert Blendon and a team of highly respected survey researchers have assembled the latest polling data in an attempt to understand the nature and extent of this backlash, which has been widely reported in the media. Blendon is professor of health policy and political analysis at Harvard University in Cambridge, Massachusetts. Mollyann Brodie is a senior researcher and director of special projects at the Henry J. Kaiser Family Foundation...
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  • Citations (196)
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References13
Newest
Published on Jan 1, 1998in Health Affairs5.71
Mollyann Brodie20
Estimated H-index: 20
,
Lee Ann Brady1
Estimated H-index: 1
,
Drew E. Altman23
Estimated H-index: 23
PROLOGUE: Since the rapid emergence of managed care as the insurance alternative favored by private and public purchasers, many persons believe that media coverage has heavily influenced public opinion regarding it. The American Association of Health Plans, the Washington-based voice of managed care, has taken strong exception to the most sensational coverage, asserting that because much of it is usually based on individual anecdotes, the public's opinion of the whole enterprise is distorted. Ho...
Published on Sep 1, 1997in Health Affairs5.71
Robert H. Miller22
Estimated H-index: 22
,
Harold S. Luft45
Estimated H-index: 45
Prologue: One of the current realities of health policy making is that anecdotes far outweigh solid evidence when it comes to shaping the attitudes of people in relation to the performance of managed care. This phenomenon has been driven by legislators looking for political expedients that respond to a growing but still small number of consumer complaints and by media coverage that focuses on individual events rather than a broader picture of the impact of managed care. This paper aims to go bey...
Published on Aug 1, 1997in Journal of Economic Perspectives6.45
Robert J. Blendon46
Estimated H-index: 46
(Harvard University),
John M. Benson35
Estimated H-index: 35
(Harvard University)
+ 5 AuthorsMatt James1
Estimated H-index: 1
(Kaiser Family Foundation)
This paper reports the results of two parallel 1996 surveys, one of economists, one of the public. It finds that the public has a bleaker picture of what has happened economically to the average family and is more pessimistic than most economists about the intermediate future. The public cites different reasons than economists do for why the economy is not doing better. Also, individuals' perceptions of their own economic experiences yield a different set of beliefs about economic conditions tha...
Published on Apr 16, 1997in JAMA51.27
Robert J. Blendon46
Estimated H-index: 46
,
John M. Benson35
Estimated H-index: 35
+ 4 AuthorsMatt James7
Estimated H-index: 7
OVER THE past decade, health care has emerged as an important issue for voters in national elections. 1,2 As a result, political leaders from both parties have been shown to pay increasing attention to the views of voters when selecting their health care priorities and positions for the next administration and Congress. 3,4 What message about health care policy should our elected officials, the health care community, and the American people take from the 1996 presidential and congressional elect...
Published on Jan 1, 1996in Health Affairs5.71
Karen Donelan42
Estimated H-index: 42
,
Robert J. Blendon46
Estimated H-index: 46
+ 2 AuthorsHumphrey Taylor8
Estimated H-index: 8
Abstract: We present data on patients' experiences with access to and cost and quality of health services in the United States, Canada, and Germany. In general, patients report favorably about their care. U.S. respondents report more problems with access to care, even controlling for the severe problems of the uninsured. Differences in managed care versus fee-for-service plans in the United States mirror some of the problems observed in international comparisons—access to specialists and tests a...
Published on Jan 1, 1995in Health Affairs5.71
Robert J. Blendon46
Estimated H-index: 46
(Harvard University),
John M. Benson35
Estimated H-index: 35
(Harvard University)
+ 4 AuthorsDaniel Gitterman2
Estimated H-index: 2
(Harvard University)
Abstract: A 1994 opinion survey again shows Americans less satisfied with their health care system than Canadians and (West) Germans are with theirs. Americans also report more problems in paying for care and receiving needed services. However, overall satisfaction in Canada and Germany has fallen. Important cultural differences between the countries were identified. Americans have higher expectations for medicine and a stronger preference for spending more nationally on health care. The most dr...
Published on Jan 1, 1995in Health Affairs5.71
Robert J. Blendon46
Estimated H-index: 46
,
Mollyann Brodie20
Estimated H-index: 20
,
John M. Benson35
Estimated H-index: 35
Prologue: Nearly a year has passed since Congress declared the demise of health care reform, at least for the current legislative session. However, the problems that drove the 1993-1994 health reform effort remain and, indeed, are growing worse in many cases. In this study Robert Blendon and colleagues examine public opinion polls during the 1993-1994 period to attempt to understand why Americans' strong initial support for health care reform—and specifically the Clinton administration s managed...
Published on Jan 24, 1992in Public Opinion Quarterly3.31
Kelly D. Patterson7
Estimated H-index: 7
(Inter-university Consortium for Political and Social Research),
David B. Magleby12
Estimated H-index: 12
(Inter-university Consortium for Political and Social Research)
Recent scandals in Congress have once again focused the public's attention on the operation of the legislative branch of government. Public attitudes toward institutions of democratic governance are important predictors of their health and vigor. If the institutions are evaluated positively by the public, then the democracy is said to be stable (Lipset and Schneider 1983). This is particularly true of public attitudes toward Congress, which was designed to be the "people's branch," especially th...
Published on Jan 1, 1989in Social Science History0.70
Lawrence R. Jacobs28
Estimated H-index: 28
,
Robert Y. Shapiro28
Estimated H-index: 28
THE STUDY of mass public opinion has been an important area of social science research, and it has been of particular concern for political scientists, because the relationship between public opinion and government policy is central to theories about democracy and political power (e.g., see Dahl, 1956; Downs, 1957; Devine, 1970; Weissberg, 1976). Our main argument in this essay is that political scientists and others should be open to a variety of approaches in studying trends in public opinion ...
Cited By196
Newest
Published on Feb 21, 2019in International Economic Review1.45
Jan Boone19
Estimated H-index: 19
(Tilburg University),
Christoph Schottmüller3
Estimated H-index: 3
(University of Cologne)
Published on Mar 1, 2019in Healthcare
Timothy J. Judson5
Estimated H-index: 5
(UCSF: University of California, San Francisco),
Matthew J. Press10
Estimated H-index: 10
(UPenn: University of Pennsylvania),
Allan S. Detsky68
Estimated H-index: 68
(U of T: University of Toronto)
Abstract Hospitals are increasingly shifting toward value-based reimbursement and focusing on cost consciousness and patient experience. These concepts are crucial to high-quality, affordable healthcare. However, physicians are not well-trained in factoring cost and patient experience into clinical decisions. The addition of these ideas may create the opportunity for patient harm by depriving patients of necessary care. We discuss ways for physicians to mitigate this risk by engaging in online h...
Published on Jan 1, 2019
Andrew D. Schreiner2
Estimated H-index: 2
(MUSC: Medical University of South Carolina),
Keri T. Holmes-Maybank (MUSC: Medical University of South Carolina)+ 3 AuthorsWilliam P. Moran9
Estimated H-index: 9
(MUSC: Medical University of South Carolina)
Published on Sep 1, 2018in Health Affairs5.71
Glenn Melnick21
Estimated H-index: 21
(SC: University of Southern California),
Katya Fonkych3
Estimated H-index: 3
,
Jack Zwanziger26
Estimated H-index: 26
California became very successful in controlling rising health care costs by promoting price competition through market-based, managed care policies. However, recent data reveal that the state has not been able sustain its initial success in controlling growth in hospital prices. Two powerful trends emerged in California that eroded the conditions needed to sustain price competition. To ensure timely access to emergency hospital services, government regulators enacted regulations that had the un...
Published on Sep 1, 2018in Health Affairs5.71
Alain C. Enthoven31
Estimated H-index: 31
(Graduate School USA),
Laurence C. Baker46
Estimated H-index: 46
(Stanford University)
Managed competition is a concept that was born in California and has achieved a measure of acceptance there. As California and the United States as a whole continue to struggle with the challenge of providing high-quality health care at a manageable cost, it is worth asking whether managed competition—with its tools for harnessing market forces—continues to hold promise as a means of improving value in health care, and whether the standard conceptualization of managed competition should be modif...
Published on Feb 1, 2017in Journal of Health Politics Policy and Law1.84
Philip Rocco7
Estimated H-index: 7
(Marquette University),
Andrew S. Kelly3
Estimated H-index: 3
(Johns Hopkins University)
+ 1 AuthorsMichael Kinane1
Estimated H-index: 1
(University of California, Berkeley)
Published on Jan 1, 2017
Francesco Taroni13
Estimated H-index: 13
(UNIBO: University of Bologna)
News media are the principal conduit of information about medicine and shape the attitudes of public opinion, physicians, researchers, and policy-makers. However, researchers and policy advocates deem media health with opposing attitudes: they are faulted as courting sensationalism and raising expectations but are also used for promoting behavioral changes from adopting healthier lifestyles to choosing health insurance plans. In fact, different media have different effects in communicating diffe...
Published on Jan 1, 2017
Timo Schulte3
Estimated H-index: 3
,
Alexander Pimperl4
Estimated H-index: 4
+ 1 AuthorsSabine Bohnet-Joschko1
Estimated H-index: 1
Das US-amerikanische Gesundheitssystem ist seit vielen Jahren Spitzenreiter bei den Gesundheitsausgaben, sowohl in Bezug auf deren Hohe pro Kopf als auch in Bezug auf das relative Wachstum (OECD 2015). Entsprechend gros ist – wie auch in anderen entwickelten Landern – der Reformdruck zur Verbesserung der Effektivitat und der Effizienz des Gesundheitssystems bzw. zur Verbesserung des Triple Aim (Berwick et al. 2008).
Published on Dec 1, 2016in Journal of Law Medicine & Ethics0.73
William M. Sage21
Estimated H-index: 21
Tracing the evolution of political conversations about health care spending and their relationship to the formation of policy is a valuable exercise. Health care spending is about science and ethics, markets and government, freedom and community. By the late 1980s the unique upward trajectory of post-Medicare U.S. health care spending had been established, recessions and tax cuts were eroding federal and state budgets, and efforts to harness market forces to serve policy goals were accelerating....
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