Managed Care
Disease
Management

With Updating, Old Ways Often Prove To Be Worthwhile

MANAGED CARE March 2004. © MediMedia USA
Editor's Memo

With Updating, Old Ways Often Prove To Be Worthwhile

John A. Marcille
MANAGED CARE March 2004. ©MediMedia USA

John A. Marcille

Everyone reading this has a better life than the vast majority of people who have ever lived. The most impoverished among us has a standard of living that the kings of old could only dream about. There's a saying in some countries that goes something like this: "If you have to be poor, be poor in America."

Of course, you'd never know that by looking at the faces that pass in the street or the murky dissatisfaction that roils our inner lives.

Recent books dwell on the issue: Why are we so unhappy when, by any objective and historical standard, we have no right to be? Others can try to answer that one, but we'll just make this observation.

This unhappiness, this dissatisfaction, may be the reason why we constantly strive to make things better, to test and then retest solutions to problems.

Like narrow networks, the subject of our cover story. Once upon a time managed care looked to these networks as part of the cost-containment solution. But consumers didn't like the lack of choice. So the networks broadened, at a time when premiums were static. Now, consumers are not satisfied with rising copayments and premiums. Narrow networks return.

As the story points out, this time information technology is a factor. "After all, physicians in the early '90s could not get online and access a database showing how their prices and practices measured up to those of their colleagues," the story notes. Also, employers can offer more than just narrow networks, thereby reducing the impetus for consumer backlash.

We hope. But it's not in our unhappy nature to just let well enough alone.