The war effort demanded that maximum productivity be achieved by uniting workers and employers with a common sense of mission and purpose. With the support of President Franklin Roosevelt's psychologically sophisticated advisors, American industry became a willing third-party payor with pretax dollars for health care insurance. Employers thereby became united with labor unions to effectively circumvent the existing wage controls. Any additional employer costs were more than offset by employers benefiting from increased worker productivity. Among the most attractive of MCOs' promises was that money could be saved by contracting with MCOs to keep health care costs down and to promote prevention.
Recent polls indicate that quality of health care is one of today's vital issues for voters.
Even as this editorial is being written the Supreme Court has taken the question under review. The article reported a follow-up to 1997 survey results which indicated that 1 in 4 American families had at least one adult who had provided care for an elderly relative or friend in the prior 12 months. It is a reasonable inference that per affected wage earner, the cost to both employers and taxpayers of undertreated illness due to a lack of family health care coverage or MCO restriction of care alone far exceeds the costs to the employee. In this context it is important that physicians have begun to provide alternative models to the dominance of managed care organizational control for communities and employers concerned with both health care cost and quality. One such model can be seen in a recent article published by alumnus Dr.