In an HMO, the member is offered a specific list of doctors and hospitals from whom he or she must receive care in order to be covered. This type of plan is the cheapest but most restrictive. Three other types of managed care plans are available. A PPO contracts with doctors and specialists to provide care at discounted rates. A POS plan is similar to a PPO, in that members can receive care from a certain list of doctors and specialists who've contracted with that insurer.
Cost is the primary reason so many people are joining managed care plans.
Managed care seeks to control more how doctors treat patients to prevent overtreatment and higher costs. When profit, not health, is the objective, it poses a real threat to the doctor-patient relationship, to academic medical centers, to medical research, and to those who are unable to obtain health insurance. HMOs cannot assure us that physicians will, in every instance, put their patients first. A major legal battle usually followed in response to the HMO's refusal to provide coverage. Nelene Fox was a patient who was found to have breast cancer in 1991 at the age of 38.