Meanwhile, our focus should now assess the whole issue, dated back to early 90s when the Managed-Care system began to have it solid root. The United States Congress has brought a turning point toward enhancing the health care system within U S. "The nation's health care system stem was under microscope, undergoing a level of scrutiny not seen since the early 1990s, when congress scrapped the Clinton administration's complex plan to overhaul health care. Since then, employers have acted on their own to control health costs, largely by requiring employees to join managed-care programs, such as health maintenance organizations (HMOs). More than 100 millions Americans are now covered by Managed-Care". (Public Agenda).
The HMOs is one of the key pillars of which the Managed-Care program stands on, while observers concluded that it is almost the best among other related pillars. Another branch of Managed-Care that also need brief explanation is "Capitation", a system that involves a sort of payment method. This involves paying physicians a specific amount for treatment of patients, not considering how much will be the subsequent cost to be incur.
"Some "Managed Care" practices seek to impact the quality care of, for instance, clinical guidelines that aim to alter the clinical management of specific health concerns (e.g., treatment of hypertension) are also common managed-care practice". (Ethics in Medicine).
This is only a nutshell explanation on "Capitation" of managed-care that maintains the expenses of health care.
One of the important effects that we ought to bring into consideration while discussing on the Managed-Care on health care in the United States is that most of the citizens were in the view that "Managed-Care has reduce the unnecessary spending, while patients were receiving immediate care with the adaptation of this system, even though in another hand the system (managed-care) bring a new relationship between the patients and the doctors they are assigned to.
For example, in some instances in the Unites States, Health Care Maintenance Organizations do not accept to involve patient while contracting with physicians, thus it can turn the relationship between patient and the physicians sour, because mostly they only offer to pay physicians small amount from what they charged from the patients by putting restriction for interactions between the physicians and the patients. As a result, it becomes very hard and uneasy for patients to establish rapport with physicians of their likes.