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PERSPECTIVE

Good Managed Care Needs Universal Health Insurance

Donald W. Light, PhD

20 April 1999 | Volume 130 Issue 8 | Pages 686-689

Although the increase of corporate managed care has helped to reduce excesses and costs, continued gains in cost-effectiveness depend on good clinically managed care. Benefits of clinically managed care depend on stable contracts and universal coverage. Instead, employers are decreasing coverage and creating a market of "lemons" in which low-cost plans are rewarded for cost-cutting tactics. These tactics have spawned movements that demand rights for patients and providers. Choosing to shore up those rights, however, will increase the number of uninsured persons. This tragic choice, which no other industrialized nation has permitted, will not be resolved until some form of universal health insurance is implemented.

Author and Article Information

From the University of Pennsylvania Health System, Philadelphia, Pennsylvania; and the University of Medicine and Dentistry of New Jersey, Stratford, New Jersey.

Acknowledgments: The author thanks Arthur Caplan, Jonathan Moreno, Tricia Shivas, Garth Greene, Gwynne Jenkins, and Oren Marom for helpful review of the manuscript.

Requests for Reprints: Donald W. Light, PhD, Center for Bioethics, University of Pennsylvania Health System, 3401 Market Street, Suite 320, Philadelphia, PA 19104.

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