The first phase of the revolution hasn't been perfect, but that doesn't mean it has to be abandoned. First, H.M.O.'s can develop uniform standards of care and insure that doctors adhere to them. For example, recent studies from The American College of Surgeons have shown that treatment for women with breast cancer varies according to where they live. Obviously, a woman with breast cancer shouldn't be more likely to get a mastectomy simply because she lives in the South. Second, H.M.O.'s can educate patients on what is appropriate care.
Many patients are so used to overtreatment that the proper course can seem like a deprivation.
For instance, the over use of antibiotics to treat colds has let to drug-resistant bacteria, yet patients still want all the drugs they have become accustom to. Third, managed care can be more centered around the patient. Fourth, managed-care companies can broaden the range of treatment. Studies have already shown that H.M.O.'s do a better job with preventive services like mammograms, Pap smears and immunizations. And many H.M.O.'s like Oxford are beginning to cover alternative therapies, like acupuncture and biofeedback.