Problem
Inappropriate managed care regimes
Other Names:
Profit-oriented industrialization of medicineCorporate intrusion into health care
Nature:
Managed care as typically practised in health maintenance organizations (HMOs) (as opposed to case management, see below) poses a number of dangers to the health care of individuals with disabilities and/or chronic illnesses. Similar managed-care cost-control techniques in traditional health insurance programmes pose the same risks. Essentially, the problems fall into two categories: (1) those related to economic incentives that lead to under-service, and (2) those related to the nature of this group's health-care needs. Modification of managed-care programmes may remove such dangers, but these modifications are unlikely unless policy-makers change their assumptions about and expectations for managed care.
Incidence:
In one American state, 14 HMOs cover 45% of the population of patients, and so doctors now largely depend upon HMOs to obtain patients.
Broader Problems:
Inadequate health servicesDehumanization of health care Narrower Problems:
Misconduct of medical executivesInadequate mental health insurance Related Problems:
Prohibitive medical expensesCost-conscious managed health care Aggravates:
Conflict of interest in medical doctors Strategies:
Modelling cost and effectiveness of alternative health strategiesAssessing costs and financing to meet primary health care needsContaining health costsProviding public health servicesInsuring against critical illness Subject(s):
Medicine → Medicine Commerce → Finance
Commerce → Business enterprises
Industry → Industry
Health Care → Care
Management → Management
Related UN Sustainable Development Goals:
Problem Type:
F: Fuzzy exceptional problems Date of last update
04.10.2020 – 22:48 CEST