ABSTRACT

An August 1997 Kaiser/Harvard national survey found that 51 percent of the people responding believed that managed care has decreased the quality of care for sick people (32 percent said increased). 1 In another 1997 survey, in California, 42 percent of respondents said that they had experienced a problem with their health plan, and 21 percent of these asserted that their problem involved actions that had led to worsening of their condition. 2 Patients give contradictory reports in surveys, with 79 percent in one 1996 survey agreeing with a statement that "there is something seriously wrong with our health care system," yet 57 percent in the same survey agreed that "my medical plan provides me the best quality care I could want." 3 A recent careful analysis of many surveys of public reactions to managed care concludes that the backlash is being driven by two major factors, the first being that a substantial portion of enrollees report problems with their plans. The second is "relatively rare events that seem threatening and dramatic but have been experienced by few consumers personally," like reports of a child's cancer treatment being held back. 4