The concept embodies many modes of delivering medicine, ranging from the nightmarish bureaucratic encounter to the highly professional clinic. Some forms of managed care — health maintenance organizations like Kaiser Permanente, for example — have been accepted by broad segments of the population.
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But the obvious downside of managed care is that a provider may be stingy with service and access, precisely because “fee for service” treatment is limited. In the 1990s, many patients rebelled, objecting to bureaucratic decision-making and long delays for “optional” services. To this day, managed care is criticized in many circles.
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