ProposedSolutionsProposedSolutions
Managed
Competition
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Just the Facts!
Managed
Competition is based on dividing people
into "health alliances."
These
alliances include all types of people.
Alliance members bind together to negotiate deals
with Provider Groups.
Provider
Groups are composed of doctors,
hospitals, and insurance companies.
They offer a range of health plans to choose
from.
Provider
Groups compete with each other to
attract patients.
This would help manage the cost and
quality of care.
Patients would look for the plan that offered the
best care for the best price.
The
government makes sure that the poor are enrolled
in health alliances.
Uncle Sam also monitors the quality of health
care that is available.
This
plan is among those proposed by President
Bill Clinton.
Funding
would be through taxes, employee insurance
premiums, and an "employer mandate."
The Employer
Mandate is a premium that must be paid
by employers.
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Advantages
Portability of
insurance
Universal Coverage
Accessibility - anyone can get medical
care through the system
Comprehensive - covers all necessary
care
Control costs
Control quality
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Have to deal with
"gatekeeper"
Less choice of doctors
Harder to access specialists
Quality may be reduced to keep costs down
Too much emphasis on $$$
More paperwork & administration
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This
plan has never been tried in the U.S.
Some
critics wonder if Manged Competition would do more harm than good.....
What wil happen in rural areas
where there are few people, and few doctors?
Certain plans might attract
specific types of people.
What could happen if Provider Groups
catered
to specific alliances because they are more
profitable
(such as the elderly or very sick)?
How can we ensure that alliances
and
Provider Groups represent the needs of all
members?
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