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Previous Volume 329:885-886 September 16, 1993 Number 12 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Relman, A. S.

To the Editor: Dr. Relman's editorial on "managed competition" (Jan. 14 issue)¹ is right on target. I would like to add two more points to bolster his argument.

He is correct in pointing to the "intrusive surveillance and control methods" to reduce costs used by third-party payers when they try to second-guess physicians' efforts to do what is right for patients. There is another troublesome feature of these cost-control methods. Many managed-care plans, particularly those of health maintenance organizations or preferred-provider organizations, make a patient's physician responsible for denying or approving care. This clearly puts physicians in an untenable position, . . . [Full Text of this Article]

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