The purpose of this paper is to examine how managed care affects the ability of speech-pathologists to practice, and the ensuing impact on patient services.
The trend in contemporary health care delivery is toward managed care. Opponents of managed care contend that managed care is a deceitful sham designed to maximize profits and minimize care. There has been an increasingly vocal criticism of managed care by health care providers, consumers, and some politicians.
Managed care, however, is becoming the Abackbone of health care delivery in the United States@ (Wells, et al, 1995, p. 57). Managed care has two major goals; one is to control health care costs and the second is to provide quality services that are sufficient enough to satisfy the enrollees. Several strategies based on direct control and care and indirect economic incentives are used. Payment incentives include capitation to encourage the provider to use fewer services, and co-payments and deductibles to discourage over-use of services by patients.
Managed care is part of the reform of the traditional health care system in the United States, and it is a volatile issue. Costs are the primary concern of funding providers, while the opportunity to earn profits is the primary concern of the health insurance industry, and increased access to health care services is the primary concern of social activists. Managed care was supposed to satisfy these three groups. However, critics of the managed care concept contend that an application of the concept as a basis for health care reform will result in a shifting emphasis from patient care to earning a profit. Another concern about such market-oriented reforms is that lower income people will suffer. Under managed care, individuals with higher incomes would be able to pay the extra premium costs to enroll in more expensive health plans while lower income people would not be able to afford the extra premiums, and would...