Consumer Choice and the Managed Care Backlash

American Journal of Law and Medicine

Volumn 27, Issue 1, 2001, Pages 1-15

  Enthoven, Alain C ^b   Schauffler, Helen H ^a   McMenamin, Sara ^b  

^a UNIVERSITY OF CALIFORNIA   (United States)

^b University of California ^*

Author keywords

[No Author keywords available]

Indexed keywords

ADOLESCENT; ADULT; AGED; ARTICLE; CONSUMER; DECISION MAKING; EPIDEMIOLOGY; FEMALE; HEALTH INSURANCE; HEALTH MAINTENANCE ORGANIZATION; HUMAN; LEGAL ASPECT; MALE; MIDDLE AGED; PATIENT ADVOCACY; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

ADOLESCENT; ADULT; AGED; CALIFORNIA; CHOICE BEHAVIOR; CONSUMER SATISFACTION; FEMALE; HEALTH BENEFIT PLANS, EMPLOYEE; HEALTH CARE SURVEYS; HEALTH MAINTENANCE ORGANIZATIONS; HUMANS; MALE; MIDDLE AGED; PATIENT ADVOCACY;

EID: 0035237204     PISSN: 00988588     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (43)

1. See generally Robert J. Blendon et al., Understanding the Managed Care Backlash, HEALTH AFF., July-Aug. 1998, at 80 (discussing the fears of people enrolled in managed care plans as compared to their traditionally insured peers); Thomas Bodenheimer, The HMO Backlash-Righteous or Reactionary, 335 NEW ENG. J. MED. 1601 (1996) (discussing the substantive issues raised by the backlash against HMOs); Alain C. Enthoven & Sara J. Singer, The Managed Care Backlash and The Task Force in California, HEALTH AFF. July-Aug. 1998, at 95 (reporting the findings of the California Managed Health Care Improvement Task Force); David Mechanic, Managed Care as a Target of Distrust, 277 JAMA 1810 (1997) (noting the increased public opposition to managed care).
2. See generally Robert J. Blendon et al., Understanding the Managed Care Backlash, HEALTH AFF., July-Aug. 1998, at 80 (discussing the fears of people enrolled in managed care plans as compared to their traditionally insured peers); Thomas Bodenheimer, The HMO Backlash-Righteous or Reactionary, 335 NEW ENG. J. MED. 1601 (1996) (discussing the substantive issues raised by the backlash against HMOs); Alain C. Enthoven & Sara J. Singer, The Managed Care Backlash and The Task Force in California, HEALTH AFF. July-Aug. 1998, at 95 (reporting the findings of the California Managed Health Care Improvement Task Force); David Mechanic, Managed Care as a Target of Distrust, 277 JAMA 1810 (1997) (noting the increased public opposition to managed care).
3. See generally Robert J. Blendon et al., Understanding the Managed Care Backlash, HEALTH AFF., July-Aug. 1998, at 80 (discussing the fears of people enrolled in managed care plans as compared to their traditionally insured peers); Thomas Bodenheimer, The HMO Backlash-Righteous or Reactionary, 335 NEW ENG. J. MED. 1601 (1996) (discussing the substantive issues raised by the backlash against HMOs); Alain C. Enthoven & Sara J. Singer, The Managed Care Backlash and The Task Force in California, HEALTH AFF. July-Aug. 1998, at 95 (reporting the findings of the California Managed Health Care Improvement Task Force); David Mechanic, Managed Care as a Target of Distrust, 277 JAMA 1810 (1997) (noting the increased public opposition to managed care).
4. See generally Robert J. Blendon et al., Understanding the Managed Care Backlash, HEALTH AFF., July-Aug. 1998, at 80 (discussing the fears of people enrolled in managed care plans as compared to their traditionally insured peers); Thomas Bodenheimer, The HMO Backlash-Righteous or Reactionary, 335 NEW ENG. J. MED. 1601 (1996) (discussing the substantive issues raised by the backlash against HMOs); Alain C. Enthoven & Sara J. Singer, The Managed Care Backlash and The Task Force in California, HEALTH AFF. July-Aug. 1998, at 95 (reporting the findings of the California Managed Health Care Improvement Task Force); David Mechanic, Managed Care as a Target of Distrust, 277 JAMA 1810 (1997) (noting the increased public opposition to managed care).
5. See Blendon, supra note 1, at 81; Bodenheimer, supra note 1, at 1601, Enthoven & Singer, supra note 1, at 95.
6. See, e.g., Bipartisan Patient Protection Act of 2001, S. 283, 107th Cong. (2001); Patients' Bill of Rights Act, S. 6, 107th Cong. (2001); Common Sense Patients' Bill of Rights Act, H.R. 5628, 106th Cong. (2000); Patients' Bill of Rights Act, S. 3058, 106th Cong. (2000); Quality Care for the Uninsured Act of 1999 and The Bipartisan Consensus Managed Care Improvement Act of 1999, H.R. 2990, 106th Cong. (1999); Patients' Bill of Rights Plus Act, S. 1344, 106th Cong. (1999). See also Blendon, supra note 1, at 81.
7. See William N. Tindall et al., Paving the Pathway to Managed Care Medicine (visited Feb. 14, 2001) 〈http://www.acmcm.org/CME/Pathway_Course_1.htm〉.
8. See id.
9. See Karen Davis & Cathy Schoen, Assuring Quality, Information, and Choice in Managed Care, 35 INQUIRY 104, 104 (Summer 1998); Karen Scott Collins et al., The Commonwealth Fund, The Commonwealth Fund Survey of Physician Experiences With Managed Care (visited Jan. 28, 2001) 〈http://www.cmwf.org/programs/health_care/physrvy.asp〉 [hereinafter Physician Survey].
10. See Karen Davis & Cathy Schoen, Assuring Quality, Information, and Choice in Managed Care, 35 INQUIRY 104, 104 (Summer 1998); Karen Scott Collins et al., The Commonwealth Fund, The Commonwealth Fund Survey of Physician Experiences With Managed Care (visited Jan. 28, 2001) 〈http://www.cmwf.org/programs/health_care/physrvy.asp〉 [hereinafter Physician Survey].
11. See Karen Davis & Cathy Schoen, Assuring Quality, Information, and Choice in Managed Care, 35 INQUIRY 104, 104 (Summer 1998); Karen Scott Collins et al., The Commonwealth Fund, The Commonwealth Fund Survey of Physician Experiences With Managed Care (visited Jan. 28, 2001) 〈http://www.cmwf.org/programs/health_care/physrvy.asp〉 [hereinafter Physician Survey].
12. See Physician Survey, supra note 6.
13. For more information about CalPERS, see California Public Employees' Retirement System (visited Feb. 7, 2001) 〈http://www.calpers.ca.gov〉.
14. See id.
15. For more information about FEHBP, see U.S. Office of Personnel Management, Federal Employees Health Benefits Program (visited Feb. 7, 2001) 〈http://www.opm.gov/insure/health〉.
16. See Stanford GSB News and Information, Alain C. Enthoven, Managed Care: What Went Wrong? Can It Be Fixed? (visited Feb. 14, 2001) 〈http://www.gsb.stanford.edu/services/news/enthovenozmunlecture.html〉 [hereinafter Enthoven Speech]; see also Enthoven & Singer, supra note 1, at 97.
17. See Stanford GSB News and Information, Alain C. Enthoven, Managed Care: What Went Wrong? Can It Be Fixed? (visited Feb. 14, 2001) 〈http://www.gsb.stanford.edu/services/news/enthovenozmunlecture.html〉 [hereinafter Enthoven Speech]; see also Enthoven & Singer, supra note 1, at 97.
18. See THE KAISER FAMILY FOUNDATION AND HEALTH RESEARCH AND EDUCATIONAL TRUST, EMPLOYER HEALTH BENEFITS 1999 ANNUAL SURVEY 42-54 [hereinafter Employer Health Benefits]; Enthoven Speech, supra note 11; Enthoven & Singer, supra note 1, at 97.
19. See THE KAISER FAMILY FOUNDATION AND HEALTH RESEARCH AND EDUCATIONAL TRUST, EMPLOYER HEALTH BENEFITS 1999 ANNUAL SURVEY 42-54 [hereinafter Employer Health Benefits]; Enthoven Speech, supra note 11; Enthoven & Singer, supra note 1, at 97.
20. See THE KAISER FAMILY FOUNDATION AND HEALTH RESEARCH AND EDUCATIONAL TRUST, EMPLOYER HEALTH BENEFITS 1999 ANNUAL SURVEY 42-54 [hereinafter Employer Health Benefits]; Enthoven Speech, supra note 11; Enthoven & Singer, supra note 1, at 97.
21. See Enthoven Speech, supra note 11
22. See Enthoven Speech, supra note 11; see also Karen Davis & Cathy Schoen, The Commonwealth Fund, Managed Care, Choice, and Patient Satisfaction (visited Jan. 28, 2001) 〈http://www.cmvvf.org/programs/health_care/satis.asp〉 (discussing involuntary physician changes for managed care patients) [hereinafter Patient Satisfaction].
23. See Enthoven Speech, supra note 11; see also Karen Davis & Cathy Schoen, The Commonwealth Fund, Managed Care, Choice, and Patient Satisfaction (visited Jan. 28, 2001) 〈http://www.cmvvf.org/programs/health_care/satis.asp〉 (discussing involuntary physician changes for managed care patients) [hereinafter Patient Satisfaction].
24. See Enthoven Speech, supra note 11; see also Karen Davis & Cathy Schoen, The Commonwealth Fund, Managed Care, Choice, and Patient Satisfaction (visited Jan. 28, 2001) 〈http://www.cmvvf.org/programs/health_care/satis.asp〉 (discussing involuntary physician changes for managed care patients) [hereinafter Patient Satisfaction].
25. See Enthoven Speech, supra note 11.
26. See Karen Davis et al., Choice Matters: Enrollees' Views of their Health Plans, HEALTH AFF., Summer 1995, at 99, 108-10; Enthoven & Singer, supra note 1, at 102-03; MANAGED HEALTH CARE IMPROVEMENT TASK FORCE, IMPROVING MANAGED HEALTH CARE IN CALIFORNIA: FINDINGS AND RECOMMENDATIONS VOL. 2, 18 (1998) [hereinafter FINDINGS AND RECOMMENDATIONS]; HELEN H. SCHAUFFLER & LEE D. KEMPER, CALIFORNIA CENTER FOR HEALTH IMPROVEMENT, SURVEY BRIEF TO THE MANAGED HEALTH CARE IMPROVEMENT TASK FORCE: TASK FORCE SURVEY FINDS 76% OF INSURED CALIFORNIANS SATISFIED, 42% REPORT PROBLEMS 8 (1998) [hereinafter SURVEY BRIEF].
27. See Karen Davis et al., Choice Matters: Enrollees' Views of their Health Plans, HEALTH AFF., Summer 1995, at 99, 108-10; Enthoven & Singer, supra note 1, at 102-03; MANAGED HEALTH CARE IMPROVEMENT TASK FORCE, IMPROVING MANAGED HEALTH CARE IN CALIFORNIA: FINDINGS AND RECOMMENDATIONS VOL. 2, 18 (1998) [hereinafter FINDINGS AND RECOMMENDATIONS]; HELEN H. SCHAUFFLER & LEE D. KEMPER, CALIFORNIA CENTER FOR HEALTH IMPROVEMENT, SURVEY BRIEF TO THE MANAGED HEALTH CARE IMPROVEMENT TASK FORCE: TASK FORCE SURVEY FINDS 76% OF INSURED CALIFORNIANS SATISFIED, 42% REPORT PROBLEMS 8 (1998) [hereinafter SURVEY BRIEF].
28. See Karen Davis et al., Choice Matters: Enrollees' Views of their Health Plans, HEALTH AFF., Summer 1995, at 99, 108-10; Enthoven & Singer, supra note 1, at 102-03; MANAGED HEALTH CARE IMPROVEMENT TASK FORCE, IMPROVING MANAGED HEALTH CARE IN CALIFORNIA: FINDINGS AND RECOMMENDATIONS VOL. 2, 18 (1998) [hereinafter FINDINGS AND RECOMMENDATIONS]; HELEN H. SCHAUFFLER & LEE D. KEMPER, CALIFORNIA CENTER FOR HEALTH IMPROVEMENT, SURVEY BRIEF TO THE MANAGED HEALTH CARE IMPROVEMENT TASK FORCE: TASK FORCE SURVEY FINDS 76% OF INSURED CALIFORNIANS SATISFIED, 42% REPORT PROBLEMS 8 (1998) [hereinafter SURVEY BRIEF].
29. See Karen Davis et al., Choice Matters: Enrollees' Views of their Health Plans, HEALTH AFF., Summer 1995, at 99, 108-10; Enthoven & Singer, supra note 1, at 102-03; MANAGED HEALTH CARE IMPROVEMENT TASK FORCE, IMPROVING MANAGED HEALTH CARE IN CALIFORNIA: FINDINGS AND RECOMMENDATIONS VOL. 2, 18 (1998) [hereinafter FINDINGS AND RECOMMENDATIONS]; HELEN H. SCHAUFFLER & LEE D. KEMPER, CALIFORNIA CENTER FOR HEALTH IMPROVEMENT, SURVEY BRIEF TO THE MANAGED HEALTH CARE IMPROVEMENT TASK FORCE: TASK FORCE SURVEY FINDS 76% OF INSURED CALIFORNIANS SATISFIED, 42% REPORT PROBLEMS 8 (1998) [hereinafter SURVEY BRIEF].
30. See Karen Davis et al., Choice Matters: Enrollees' Views of their Health Plans, HEALTH AFF., Summer 1995, at 99, 108-10; Enthoven & Singer, supra note 1, at 102-03; MANAGED HEALTH CARE IMPROVEMENT TASK FORCE, IMPROVING MANAGED HEALTH CARE IN CALIFORNIA: FINDINGS AND RECOMMENDATIONS VOL. 2, 18 (1998) [hereinafter FINDINGS AND RECOMMENDATIONS]; HELEN H. SCHAUFFLER & LEE D. KEMPER, CALIFORNIA CENTER FOR HEALTH IMPROVEMENT, SURVEY BRIEF TO THE MANAGED HEALTH CARE IMPROVEMENT TASK FORCE: TASK FORCE SURVEY FINDS 76% OF INSURED CALIFORNIANS SATISFIED, 42% REPORT PROBLEMS 8 (1998) [hereinafter SURVEY BRIEF].
31. The establishment of the California Managed Health Care Improvement Task Force was added by 1996 Cal. Stat. 815 § 1 (introduced as A.B. 2343). See CAL. HEALTH & SAFETY CODE § 1342.1 (West 2000). See also SURVEY BRIEF, supra note 15, at 1. Section II of this article discusses the survey conducted by the MCTF. For clarity's sake, individual citations to the MCTF's report to the governor have been omitted. For more information on the MCTF survey and findings, see generally FINDINGS AND RECOMMENDATIONS, supra note 15 (discussing the MCTF survey and findings).
32. See infra Table 1.
33. See infra Table 2.
34. See infra Table 3.
35. See infra Table 4.
36. See HELEN H. SCHAUFFLER ET AL., HEALTH CARE TRENDS AND INDICATORS IN CALIFORNIA AND THE UNITED STATES: A CHARTBOOK FROM THE KAISER FAMILY FOUNDATION 39, Exhibit 4.7 (2000).
37. See id. at 39, Exhibit 4.8.
38. See Employer Health Benefits, supra note 12, at 47, Exhibit 5.5.
39. See Patient Satisfaction, supra note 14.
40. See id., Table 4.
41. See id., Table 4.
42. See Davis, supra note 15, at 109.
43. See id.