as pre-admission certification, concurrent review, case management, utilization rules, and price limits (Gales, 1996, pp. 48-56). Opponents contend that managed care is a deceitful sham designed to maximize profits and minimize care (Merwin & Fox, 1992, pp. 139-149). The truth about managed care likely lies at some point along this continuum of opinion. The intent of the application of the managed care concept is to balance access to services, service quality, and the cost of services in relation to health care in the United States (Goldfield, 1994, pp. 70-80).
Waitzkin (1994, pp. 482-494) draws a parallel between the planning-programming-budget system (PPBS) concept applied by public sector organizations and the concept of managed competition (often referred to as managed care) that has been proposed as a basis for national health care reform. Waitzkin (1994, pp. 482-494) describes the application of the PPBS concept to the military health care system in the 1960s as a form of managed care. The application of the PPBS concept to the delivery of milita
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