Understanding The Managed Care Backlash

Published on Jul 1, 1998in Health Affairs5.711
· DOI :10.1377/hlthaff.17.4.80
Robert J. Blendon47
Estimated H-index: 47
Mollyann Brodie19
Estimated H-index: 19
+ 4 AuthorsLarry Hugick3
Estimated H-index: 3
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 instit...
  • References (13)
  • Citations (197)
📖 Papers frequently viewed together
371 Citations
511 Citations
62 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Mollyann BrodieH-Index: 19
#2Lee Ann BradyH-Index: 1
Last. Drew E. AltmanH-Index: 22
view all 3 authors...
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...
62 CitationsSource
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...
371 CitationsSource
#1Robert J. Blendon (Harvard University)H-Index: 47
#2John M. Benson (Harvard University)H-Index: 50
Last. Matt James (Kaiser Family Foundation)H-Index: 1
view all 8 authors...
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...
152 CitationsSource
#1Robert J. BlendonH-Index: 47
#2John M. BensonH-Index: 50
Last. Matt JamesH-Index: 7
view all 7 authors...
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...
10 CitationsSource
#1Karen DonelanH-Index: 43
#2Robert J. BlendonH-Index: 47
Last. Humphrey TaylorH-Index: 8
view all 5 authors...
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 thei...
43 CitationsSource
10 CitationsSource
#1Robert J. Blendon (Harvard University)H-Index: 47
#2John M. Benson (Harvard University)H-Index: 50
Last. Daniel Gitterman (Harvard University)H-Index: 2
view all 7 authors...
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...
44 CitationsSource
#1Robert J. BlendonH-Index: 47
#2Mollyann BrodieH-Index: 19
Last. John M. BensonH-Index: 50
view all 3 authors...
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...
48 CitationsSource
#1D PattersonKelly (Inter-university Consortium for Political and Social Research)H-Index: 9
#2David B. Magleby (Inter-university Consortium for Political and Social Research)H-Index: 12
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...
30 CitationsSource
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 ...
9 CitationsSource
Cited By197
#1Maxim L. Pinkovskiy (Federal Reserve Bank of New York)H-Index: 5
#1Jan Boone (Tilburg University)H-Index: 20
#2Christoph Schottmüller (University of Cologne)H-Index: 3
1 CitationsSource
#1Andrew D. Schreiner (MUSC: Medical University of South Carolina)H-Index: 3
#2Keri T. Holmes-Maybank (MUSC: Medical University of South Carolina)
Last. William P. Moran (MUSC: Medical University of South Carolina)H-Index: 14
view all 6 authors...
Introduction:Primary care referrals to specialty physicians once relied upon the medical skill of the specialist, the quality of past communication, and previous consultative experiences. As health...
#1Timothy J. Judson (UCSF: University of California, San Francisco)H-Index: 5
#2Matthew J. Press (UPenn: University of Pennsylvania)H-Index: 14
Last. Allan S. Detsky (U of T: University of Toronto)H-Index: 62
view all 3 authors...
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...
1 CitationsSource
#1Alain C. Enthoven (Graduate School USA)H-Index: 31
#2Laurence C. Baker (Stanford University)H-Index: 47
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...
#1Glenn Melnick (SC: University of Southern California)H-Index: 21
#2Katya FonkychH-Index: 3
Last. Jack ZwanzigerH-Index: 28
view all 3 authors...
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...
#1Philip Rocco (Marquette University)H-Index: 7
#2Andrew S. Kelly (Johns Hopkins University)H-Index: 3
Last. Michael Kinane (University of California, Berkeley)H-Index: 1
view all 4 authors...
1 CitationsSource
#1Francesco Taroni (UNIBO: University of Bologna)H-Index: 13
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...
#1Timo SchulteH-Index: 4
#2Alexander PimperlH-Index: 4
Last. Sabine Bohnet-JoschkoH-Index: 2
view all 4 authors...
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).
1 CitationsSource