Demanding Medical Excellence Doctors and Accountability in the Information Age

Millenson, Michael L.

doi:10.1016/s0033-3506(00)00397-8

Cited by 33 publications

(37 citation statements)

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“…There is limited accountability (Millenson 1999). The patient has little power, expertise, legal recourse or resources to unravel the behind-the-scenes agreements that constitute a care system designed to use the patient for profit.…”

Section: Discussionmentioning

confidence: 99%

Rationing health care to disabled people

Albrecht

2001

Sociology Health & Illness

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Combining a political economic perspective with a case study approach, this paper examines the intent, process, and consequences of rationed care for disabled people under the U.S. managed care system. Two disabled persons were followed over a three-year period as they sought care for major episodes relating to chronic depression and post-polio syndrome. The findings illustrate a marked disparity between the concept and goals of rationed care and the experience of consumers of services. For these people, care is rationed at the service level and also in terms of restricted access to, and payment for, the care sought. This often results in inadequate treatment and inflated costs. These problems are due in large part to the competitive nature of the major stakeholders, institutional coalitions that work against patients, emphasis on profit maximisation, devaluing of the lives of disabled people and the weak bargaining position that disabled persons hold as consumers.

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Section: Discussionmentioning

confidence: 99%

Rationing health care to disabled people

Albrecht

2001

Sociology Health & Illness

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“…This provides many opportunities-still unrealized-to build intelligence through effective information systems, to implement practice guidelines and management systems, and to disseminate treatment information (Millenson 1997). It also provides an easy target for opponents who would attribute any of the thousands of errors and contested judgments that occur in any medical care system to the structures and strategies of the central organization (Mechanic 1997).…”

Section: Lack Of Public Trust Fuels Backlashmentioning

confidence: 99%

The Managed Care Backlash: Perceptions and Rhetoric in Health Care Policy and the Potential for Health Care Reform

Mechanic

2001

Milbank Quarterly

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The focus on managed care and the managed care backlash divert attention from more important national health issues, such as insurance coverage and quality of care. The ongoing public debate often does not accurately convey the key issues or the relevant evidence. Important perceptions of reduced encounter time with physicians, limitations on physicians' ability to communicate options to patients, and blocked access to inpatient care, among others, are either incorrect or exaggerated. The public backlash reflects a lack of trust resulting from cost constraints, explicit rationing, and media coverage. Inevitable errors are now readily attributed to managed care practices and organizations. Some procedural consumer protections may help restore the eroding trust and refocus public discussion on more central issues.

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“…28 However, for the reasons outlined earlier, most MCOs have not initiated disease management programs to support the activities of their contracted networks. Acting collaboratively, plans could do a number of things to improve management of asthma while reducing hospitalization rates.…”

Section: Collaboration To Improve Clinical Effectivenessmentioning

confidence: 99%

Bringing Collaboration Into The Market Paradigm

Berenson

1998

Health Affairs

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The market competition paradigm assumes that health plans will compete on many factors, including quality of care. Unfortunately, for many reasons health plans have not made a substantial effort to distinguish themselves on quality. The antitrust laws that are designed to protect competition allow selective collaboration among competitors for various purposes, including quality improvement. Within antitrust constraints, specific opportunities exist for competing health plans to collaborate to improve quality. Their success will depend on purchasers' ability to demand such collaborative efforts as part of their overall purchasing strategy.

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Demanding Medical Excellence Doctors and Accountability in the Information Age

Cited by 33 publications

References 0 publications

Rationing health care to disabled people

Rationing health care to disabled people

The Managed Care Backlash: Perceptions and Rhetoric in Health Care Policy and the Potential for Health Care Reform

Bringing Collaboration Into The Market Paradigm

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