FAMILY HEALTH CARE COSTS Introd

Health care economics is entering another state of turmoil in the United States as the moderating effects of the managed care concept on increasing health care costs appears to have run its course. The Congress and state governments believed the promises of managed care proponents (that managed care would lower health care costs dramatically) and are resisting rapid increases in health care costs. Managed care companies are responding by dropping governmentally-funded patient groups (including Medicare and Medicaid), raising charges to businesses, families, and individuals enrolled in the managed care plans, reducing reimbursement levels to provider groups, and restricting access to health services and procedures. As a consequence, the health care system in the United States appears to be in the same untenable position that it was in the early- to mid-1990s, when managed care emerged as the dominant model in the health care system. The thesis of this paper is that (a) managed care per se is not the problem, (b) rather, the problem is a complex maze of related issues that focus on funding mechanism, delivery structure, and individual responsibility, and (c) the only effective long-term solution to the problem is a national health care system based on the concept of universality (universal access to health care services among members of a population).

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