Shi and Singh (2008:57) have proposed that managed care is not positioned to work in Medicare. Managed care is a set of parameters that include health financing, insurance, service delivery, and payments. Healthcare is built on the aspect of curative rather than preventive strategies. Managed care doesn’t address predisposing factors to causes of diseases. For instance, while research work is seeking management of cancer, the government provides subsidies to the tobacco industry. This predisposes conflict of interest and is fueled by the existence of political rhetoric trait that undermines the sustainability of managed care.
The sustainability of managed care is negatively affected by a core belief in capitalism as this makes healthcare service like any other by capitalizing on the maximization of profit which needs a turnaround. As a result, managed care is under threat from possible conflict of interest between the insurance and health care service delivery. This is due to consideration of service delivery as a function of price charged (Shi & Singh, 2008:56-64).
Managed care has adopted the market value subject to cost control aspects, choice restrictions, and case management which have shifted managed care from public regulation to private regulation (Hellinger, 1998:835). This has witnessed a shift from public planning into corporate planning. In this respect, managed care strives to achieve the values of bringing in returns on investment. This burdens persons who are not insured as it introduces the element of corruption and lack of basic health benefits. Better strategies are required in case management.
Managed care does not achieve the aspect of equity but fuels healthcare as an element of opportunity hence is not likely to seem to work in Medicare. There should be equity in managed care (White, 2009).
References
Hellinger, F. J. (1998). The effect of managed care on quality: A review of recent evidence. Archives of Internal Medicine, 158:833-841.
Shi, L., & Singh, D. A. (2008). Essentials of the U.S. Health Care System, Canada: Jones & Bartlett Publishers p. 56-64.
White, J. (2009). Cost control and health care reform: the case for all-payer regulation. Washington, DC: Campaign for America’s Future. Web.