Down A fter practicing for many years in California where managed care is already the norm, I have come to the conclusion that there are good, bad and ugly aspects to this system of health care. Incentive for cost-effective scientific advances. Incentive for care at home because it's cheaper than institutional care. More physician involvement because physicians are called upon to be gatekeepers and to be aware of patient outcomes. Consolidation of companies can lead to more efficient delivery of services.
Integrated networks can provide to varying degrees all required services.
Less choice of health care providers. Lower reimbursement for providers could mean providers are less willing to give care. Lower standards for clinicians. Denial of newer therapies. The insurance maze created by MCOs and government bureaucracy.