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Book Review
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Volume 336:517 February 13, 1997 Number 7
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Health against Wealth: HMOs and the breakdown of medical trust

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By George Anders. 299 pp. Boston, Houghton Mifflin, 1996. $22.95. ISBN 0-395-82283-1.

The central tension in managed-care systems is between policies and practices that provide all the care that is in the best interest of the patient, and only that care, and an American tradition in which all possible care is provided, especially heroic interventions involving advanced forms of technology, regardless of evidence of benefit. This book describes what happens when consumers and physicians who have been happy with "all possible care" encounter the world of "all and only the care that has benefit."

In an early chapter, the author acknowledges that managed care came into being to solve a problem — . . . [Full Text of this Article]




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