Is Managed Care Really Here to Stay?

Patrick B. Mullen, MD
JAMA. 1997;277(24):1934. doi:10.1001/jama.1997.03540480034033.
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To the Editor.  —Dr Fuchs betrays his deep sympathy for managed care in his Commentary.1 Terms like "efficiency" and "economies of scale" are all relative statistical descriptions and can be applied to any abstraction one cares to choose. The dismal science of economics has little to offer the profession of medicine, and Fuchs' article shows that. Apparently, he has not had any direct dealings with managed care.Suppose that a pure free market for economics professors existed. My guess is that it would resemble the system of care and reimbursement that we have enjoyed for many years. Then add conglomerate economic decision making, the new market force, back it up with computer-generated information, and make rules enforced by government that impede associations of economists from "competing." Watch Fuchs change his tone when the blind greed of corporate America turns on him.All physicians have been to meetings at which the solo practitioner


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