The Managed Care Blues and How to Cure Them / Edition 1

by Walter A. Zelman, Robert A. Berenson

Overview

Shattering the myths about what’s wrong with managed health care, this penetrating introduction to managed care explains its origins and identifies its real achievements and shortcomings.

Walter A. Zelman and Robert A. Berenson argue that many criticisms of managed care tend to idealize the costly and fragmented insurance system it supplanted, without pinpointing the true inadequacies of today’s managed care. In addition to providing reasoned answers to the most alarmist critiques of managed care, the authors maintain that it has not fulfilled its potential to improve the overall quality of care.

The authors propose thirteen concrete recommendations for raising quality in managed care programs, ranging from enacting additional legal protections and increased disclosure to putting the purchasing power in the hands of those who care most about quality — individuals, rather than employers.

With practical solutions for making managed care better, The Managed Care Blues and How to Cure Them is a bold call for greater consumer protection, knowledge, and power in the health care arena.

Product Details

ISBN-13:	9780878406807
Publisher:	Georgetown University Press
Publication date:	09/01/1998
Edition description:	New Edition
Pages:	240
Product dimensions:	6.00(w) x 9.00(h) x 0.60(d)
Lexile:	1370L (what's this?)
Age Range:	18 Years

About the Author

Walter A. Zelman is an instructor in health policy and management at the School of Public Health at Harvard University. He has served as a special deputy to the commissioner of the California Department of Insurance and as the California director of Common Cause, the public interest group.

Robert A. Berenson, MD, is currently director of the Center for Health Policy Plus and Providers in the Health Care Financing Administration, Department of Health and Human Services. He has practiced medicine for more than twenty years and was the founder and medical director of the National Capital Preferred Provider Organization.

Both authors have served as health policy advisors to the White House.

What People are Saying About This

Karen Ignagni

A provocative account of where our health care system is, where it was, and where it is going. It broadens the debate and raises compelling questions for all stakeholders.
—( Karen Ignagni, President, American Association of Health Plans )

Philip R. Lee

At long last, an honest, frank appraisal of managed care, by two of the nation's most respected policy analysts. A must read for anyone concerned about these critical issues (Philip R. Lee, M.D. is former Secretary of Health, and Professor Emeritus, School of Medicine, University of California, San Francisco).

Jon Gabel

Zelman and Berenson have written one of the most important health policy books of the decade. It identifies the phony managed care issues—false consumerism and hysteria over anecdotes and then moves on to the true issues—its failure to fulfill its potential to improve quality of care and to build a system of evidenced-based care. Their ability to explain the complex simply makes the reading a pleasure.
—(Jon Gabel, Director, Center for Survey Research, KPMG Peat Marwick, LLP )

From the Publisher

"At long last, an honest, frank appraisal of managed care, by two of the nation's most respected policy analysts. A must read for anyone concerned about these critical issues."—Philip R. Lee, MD, former Secretary of Health and professor emeritus, School of Medicine, University of California, San Francisco

"Zelman and Berenson have written one of the most important health policy books of the decade. It identifies the phony managed care issues—false consumerism and hysteria over anecdotes and then moves on to the true issues—its failure to fulfill its potential to improve quality of care and to build a system of evidenced-based care. Their ability to explain the complex simply makes the reading a pleasure."—Jon Gabel, director, Center for Survey Research, KPMG Peat Marwick, LLP

"A provocative account of where our health care system is, where it was, and where it is going. It broadens the debate and raises compelling questions for all stakeholders."—Karen Ignagni, president, American Association of Health Plans

Editorial Reviews

Reviewer: Anna Maio, MD (Creighton University Medical Center)
Description: This book discusses the failure of our previous insurance system and the rise of managed care. The authors also present the negatives and positives of managed care and offer strategies to improve its quality.
Purpose: The purpose is to provide a candid and balanced assessment of managed care today.
Audience: This book is written for all who would like a candid and balanced view of managed care. The authors state, however, that the book is not written for those involved in health services research since most of the material would already be known to them. The authors bring different experiences to the book. Robert Berenson is a physician and Walter Zelman has been a political activist involved in insurance reform. They both participated in the failed Clinton Health Care Reform effort.
Features: Information is delivered in an organized format. An outline of the failure of our previous system and a discussion of its quality issues are followed by a detailed overview of managed care including its beginning, quality improvement, and cost issues. The final chapter offers 13 steps to raise the quality of managed care. A song title or phrase is the subtitle of each chapter and ties in well with the title of the book, in addition to increasing the reader's enjoyment. Any graphs or drawings are quite minimal and are few and far between.
Assessment: Since managed care is here to stay awhile, this book helps the reader to chase away the managed care blues. After reading the chapter on strategies to improve quality, I found myself more hopeful and better prepared to participate in the progress.

Doody's Review Service

Timely . . . presents a well balanced review of the managed health care world as it actually exists. . . . provides a fine resource for those who genuinely want, or need, to take a balanced review of managed health care . . . The authors provide a worthy service in elucidating, as clearly and articulately as one might hope, a fair discussion of issues in the industry.

Healthplan

A provocative account of where our health care system is, where it was, and where it is going. It broadens the debate and raises compelling questions for all stakeholders.

Karen Ignagni

Zelman and Berenson have written one of the most important health policy books of the decade. It identifies the phony managed care issues—false consumerism and hysteria over anecdotes and then moves on to the true issues—its failure to fulfill its potential to improve quality of care and to build a system of evidenced-based care. Their ability to explain the complex simply makes the reading a pleasure.

Jon Gabel

At long last, an honest, frank appraisal of managed care, by two of the nation’s most respected policy analysts. A must read for anyone concerned about these critical issues.

Philip R. Lee

3 Stars from Doody

This book discusses the failure of our previous insurance system and the rise of managed care. The authors also present the negatives and positives of managed care and offer strategies to improve its quality. The purpose is to provide a candid and balanced assessment of managed care today. This book is written for all who would like a candid and balanced view of managed care. The authors state, however, that the book is not written for those involved in health services research since most of the material would already be known to them. The authors bring different experiences to the book. Robert Berenson is a physician and Walter Zelman has been a political activist involved in insurance reform. They both participated in the failed Clinton Health Care Reform effort. Information is delivered in an organized format. An outline of the failure of our previous system and a discussion of its quality issues are followed by a detailed overview of managed care including its beginning, quality improvement, and cost issues. The final chapter offers 13 steps to raise the quality of managed care. A song title or phrase is the subtitle of each chapter and ties in well with the title of the book, in addition to increasing the reader's enjoyment. Any graphs or drawings are quite minimal and are few and far between. Since managed care is here to stay awhile, this book helps the reader to chase away the managed care blues. After reading the chapter on strategies to improve quality, I found myself more hopeful and better prepared to participate in the progress.

Anna Maio

Zelman (public health, Harvard) and Berenson (an official in the U.S. Department of Health and Human Services) attempt a clear-headed analysis of managed care, both its strengths and weaknesses. They argue that critics of the new system overly romanticize the old one, and disregard the considerable savings that are one result of the change. However, they also suggest needed reforms to improve quality of care and consumer empowerment under the managed care system. Paper edition (unseen), $17.95. Annotation c. by Book News, Inc., Portland, Or.

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