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Health Against Wealth

Deborah Shlian, MD, MBA
JAMA. 1996;276(23):1919. doi:10.1001/jama.1996.03540230069039.
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Whether you are for or against managed care, this book is a must-read. George Anders, senior writer for the Wall Street Journal, has spent the last 4 years covering the health care marketplace. To write Health Against Wealth he took a year's sabbatical, researching the industry in depth and talking with every level of provider, payer, and consumer. The result is an outsider's critical, often provocative, but generally balanced view of managed care and managed care organizations. Although he still favors the philosophy of managed care, Anders acknowledges the inherent difficulties in balancing business performance promised to stockholders with quality and quantity of health care delivered to health maintenance organization (HMO) enrollees—especially as sicker and older people sign up with managed care plans.

In the early part of the book, Anders outlines the economic and social pressures spurring the accelerated growth of the managed care revolution. He explains that the


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