Reference of and comparison between managed care and traditional medical insurance in America
10.3760/cma.j.issn.1000-6672.2010.11.028
- VernacularTitle:美国管理式医疗保险与传统医疗保险的比较与借鉴
- Author:
Liuzhen XIAO
- Publication Type:Journal Article
- Keywords:
United States;
Managed care;
Traditional health insurance
- From:
Chinese Journal of Hospital Administration
2010;26(11):871-876
- CountryChina
- Language:Chinese
-
Abstract:
Managed care insurance is growing into the mainstream health insurance model in the United States. The differences between this and the traditional health insurance lie in their economic model, their autonomy of consumers in their choices of suppliers, their economic risk exposure for clinicians, their effect on utilization review and their impact to clinical decision-making. Managed care can only, in terms of cost constraints, affect or limit the autonomy of medical decision, instead of making decisions in lieu of clinicians. Under managed care, both the professional risk of clinicians and health benefits of consumers are exposed to obvious negative influence. In the meantime, the model is facing growing difficulties in the future for the market itself. In this regard, prudence is required to introduce managed care in China.
