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.

Financial funding model of basic medical service reform should shift from single paying attention to supply of medical services to coordination concern about medical service output.No fault medical damage compensation system should be included in the budget arrangement of national financial investment.In the face of high incidence of medical damage,the center of medical tort liability system should be changed from relief patients to prevention of medical injury.Negligence litigation system has a profound negative impact on health care system.Most attention to this negative influence should be paid when efforts are made to promote managed care.It is necessary to change basic medical service system linking with current medical tort liability system so as to design from a more macro perspective of system supply.

OBJECTIVETo study the characteristics of the arch form of skeletal Class III malocclusion and provide references for diagnosis and treatment plan.

METHODS7 indexes in dental casts of 47 patients with skeletal Class III malocclusion and 50 individuals with normal occlusion were measured respectively. And differences between corresponding upper and lower measurements were calculated. Independent samples t-test was employed for comparing between the two groups by SPSS 17.0.

RESULTSCompared with normal occlusion sample, Class III malocclusion group had smaller anterior segment lengths and larger canine angles (P<0.05). Differences between upper and lower first premolar widths were larger in males with skeletal Class III malocclusion. And differences between upper and lower anterior segment lengths were smaller in males with skeletal Class III malocclusion (P<0.05).

CONCLUSIONArch widths of patients with skeletal Class III malocclusion are basically normal. The lengths of anterior segment are smaller and the anterior arch forms are straighter.

Bicuspid ; Dental Arch ; Dental Occlusion ; Female ; Humans ; Male ; Malocclusion, Angle Class II ; Malocclusion, Angle Class III