ABSTRACT
Physicians have apparently been no happier than patients: Over half of doctors responding to a 1995 survey said that the health system was deteriorating, especially in areas served by managed care providers. The idea of an organization that would combine insurance and the provision of a full range of medical services for a fixed monthly fee has been an institutional reality since Henry J. Kaiser created in the 1930s what is now known as Kaiser Permanente to meet the needs of employees in an isolated location. Despite lower increases in health care premiums in recent years and the faith of employers that shifting their employees to managed care will save lots of money, the evidence so far is not clear. Critics contend that managed care does not save much money. The greatest advantages and strengths of managed care are far from being fully realized in practice.
