Focus: Washington: Form networks or fail

BMJ 1994; 308 doi: (Published 07 May 1994) Cite this as: BMJ 1994;308:1188
  1. J Roberts

    When health care leaders get together in Washington these days the conversation usually focuses on President Clinton or on congress. But not so when medical leaders gathered in late April at the sixth national managed health care conference. Almost 8000 delegates left the meeting with four messages that were repeated by businessmen, administrators, economists, politicians, and doctors.

    The first message was that, no matter what happens this year in congress, health care reform will accelerate. In fact, some speakers suggested that the term “reform” is passe. “Revolution” may be more accurate. Perhaps so. In 1988, when 900 delegates gathered at the first managed care conference, 71% of all insured Americans were covered by traditional insurance, which pays the doctor more for doing more. By 1993, 51% of insured Americans were covered by a managed care plan, which pays doctors a fee for each patient whom he or she cares for.

    That second message, the …

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