Journal of health politics, policy and law
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J Health Polit Policy Law · Apr 1997
ReviewThe health system in transition: care, cost, and coverage.
The growth in market-based contracting and the ascendency of managed care have generated substantial change in the health care delivery system. These reforms were spurred largely by private health care purchasers seeking a means for controlling the relentless growth in medical care costs. Following the private sector's lead, the two large public programs, Medicaid and Medicare, have also looked to managed care for solving their mounting expenditure problems. ⋯ At the same time, providers have recognized the competitive bargaining advantages in negotiating with health plans through their own consolidation and mergers. Unanswered in the managed care revolution is the means for financing care for the 41 million uninsured Americans. Moreover, whether the private and public sector are willing, or need, to finance the training of young physicians also hangs in the balance.