An overwhelming 80 percent of American's believe their quality of care is often compromised by their insurance plan to save money. If life were a movie, managed care providers would be the perfect embodiment of a conflicted movie character who helps everyone at a price that leaves only one person standing. Ideally, managed care is a system coordinated by a primary care gatekeeper who makes referrals to a specialist when appropriate. The system controls costs by eliminating unnecessary care while ensuring all necessary care is provided. But the system doesn't always live up to its potential.
Gatekeepers live up to their name.
Their entire job rotates around choosing the most economical health care options for patients. The gatekeeper plan often results in restricted access to specialists. Enrollees with chronic conditions, like diabetes, who require regular attention from a specialist have been forced to get a referral for every visit. The trend towards restricting access to specialists has caused a change in the health care profession too. According to the American Medical Association, more and more medical students are on track to becoming primary care givers rather than specialists because of insurance reimbursement difficulties.