HEALTH CARE EXPENDITURES ARE A MAJOR CONcern of governments in Canada and the United States. Over the past 40 years, a variety of approaches have been used to control costs, including global budgeting, managed competition, cost sharing, and pay for performance. Policy makers recognize that physicians play a central role, with some estimates suggesting that physicians control 80% of health expen...

Critics of health care reform proposals that incorporate managed competition contend that it has never been broadly implemented. However, insurance plans that combine insurance with the provision of care have been widely implemented and have been tested most extensively in California. This DataWatch explores California’s experience with health maintenance organizations (HMOs) and preferred prov...

The increased IT offshoring presents many benefits as well as challenges to today's organizations. One major challenge is the competition between the onshore and offshore sites or among the global sites in the offshoring relationship for job security, challenging projects, status and resources. The competition in offshoring relationships is complex and dynamic. Unmanaged or inappropriately mana...

BACKGROUND The intent of adopting managed care plans is to improve access to health care services while containing costs. To date, there have been a number of studies that examine the relationship between managed care and access to health care. However, the results from previous studies have been inconsistent. Specifically, previous studies did not demonstrate a clear benefit of Medicaid manage...

Integrated Care (INIC) organized a study visit for a group of 75 Europeans to Kaiser Permanente (KP) in San Francisco, USA. Kaiser Permanente is a care organization that encloses a health insurance company (''Kaiser''), primary health care doctors and medical specialists (''Permanente''), and hospitals (''Kaiser Hospital Trust''). These three divisions work closely together and are exclusive pa...

289 Dutch population, on average, has changed plans each year. Moreover, accelerating consolidation of the health insurance market has restricted meaningful choice of insurance plan. Currently, four insurance conglomerates control about 90% of the Dutch health insurance market. Recent polls suggest public dissatisfaction with private insurers, with 65% of insured people reporting that they have...

I n a recent presentation to UK physicians at Stanford University, Alain Enthoven produced a revealing insight. He had advised the Thatcher government at the outset of the internal market during the late 1980s. He had made the case that because no one understood how to manage risk in the NHS, managed competition should be piloted in some small areas first and only made a mandatory part of natio...

In common with other Organisation for Economic Cooperation and Development (OECD) countries, Australia is experiencing growth in expenditure on health care. However, while many other nations continue to pursue some variation of managed competition to address these problems, Australia has chosen a more incremental reform path, with initiatives such as the General Practice Strategy, restrictions ...

Today, physicians are perhaps the most regulated professionals in the United States, but in 1870, almost all of them were unlicensed. In most jurisdictions, anyone could hang up a shingle and practice medicine. Only the Dakota Territory and Ohio required physicians to register with local authorities. Between 1870 and 1900, the practice of medicine changed dramatically, and by 1900, almost every...

The past year was a transition, with President Biden proclaiming “America is back,” signaling change in the agenda and style of US foreign policy. Yet administration’s approach Indo-Pacific has been one both continuity change. “Strategic competition” remains focus US–China relations, tensions increasing few signs improvement. Yet, it imperative that this relationship be managed carefully years ...