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 military was a failed experiment. Waitzkin (1994, pp. 482-494) argues that, while the experience of the military health care system with PPBS raises warning flags for those who would make managed care the basis for national health care reform, the earlier experience does not ensure that managed care would be a failure as a basis for national health care reform.
Waitzkin (1994, pp. 488) concludes that managed competition, or managed care, as a basis for national health care reform may lead American health care "down a path inconsistent with the aspirations of many health workers and patients." Such a development also likely would lead to a failure of the concept of managed competition. This researcher supports these conclusions related to managed care.
Managed care is a program type that proponents claim ensures appropriate care for a wide range of medical treatments through the application of techniques such as preadmission certification, concurrent review, case management, utilization rules, and price limits (Berman, 1988, p. xi). Opponents contend that managed care is a deceitful sham designed to maximize profits and minimize care (Merwin and 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 (...