There many current forms of managed care being implemented in the United States. In most managed care plans patients pay an established fee for health care services that are delivered by a group of physicians and other services dictated by the plan. There are three main kinds of managed care plans: Health Maintenance Organizations (HMO), Preferred Provider Organizations (PPO) and Point of Service (POS) Plans. In addition to these forms of managed care, both Medicaid and Medicare represent managed care programs in the U.S. Medicaid is a jointly funded federal and state health insurance program that provides health care services to low income families and individuals. Medicare is a federal health insurance program for those over 65 years of age and older. Medicare encompasses hospital insurance for which people typically do not have to pay and medical insurance for which most people pay a monthly fee.
Regardless of which of these current managed care programs we examine in the U.S., we find inadequacy, ineptitude, excess and spiraling costs. Medicare was a state-of-the-art program when it was ushered in under the Johnson Administration in 1965. However, it has not kept pace with advances in medicine, medical technology nor the threat imposed from a rapidly aging American demographic. As many seniors are overwhelmed by rising prescription costs and as the entire system’s budget is threatened by an aging baby boomer population, the Citizens for Better Medicare (CBM) group has been lobbying congress for Medicare improvements. As executive director Tim Ryan argues, “We can and must do better for Medicare beneficiaries. CBM is committed to strengthening and improving Medicare to guarantee the financial health of the program while offering seniors more health care choices that would include coverage for prescription drugs” (Older 1).
Medicaid is also a managed care program with serious problems from fraud to charges of...