Question

What is one thing that you wish that you could change about managed care? Offer reasoning and evidence.

Answer 1

Managed Care is a health care delivery system organized to manage cost, utilization, and quality.

Change needed in managed care, I suggest for access in managed care as potential problems of the quality and access to behavioral health care under the managed care system have long been concerns of policymakers.

Reason & Evidence:

- Origin of the problem of healthcare access in the Colombia public healthcare system can not be attributed to the managed competition model, but the results show how it has contributed to widen structural and organizational barriers of access to care, as well as to the creation of new ones that do not appear in public models without competition. Therefore, the results question the introduction of this type of model in low- and middle-income countries, as they show how extraordinarily difficult it is for a regulation scheme to effectively correct market failures, despite 16 years of regulatory effort.

- In these circumstances, the insurance companies and healthcare providers ultimately determine the conditions for the population's access to healthcare, and therefore, the level of equity of access in the healthcare system.

Moreover, this research has made possible the in-depth analysis of the factors influencing access to healthcare services that have rarely been considered in research in Colombia.

- It has also allowed some of the results obtained in other studies to be interpreted, such as the presence of economic and geographical barriers in the contributory regime.

- This indicates the need for future surveys to distinguish between insurers' barriers and healthcare service barriers.

Both the health authority's inability to guarantee the provision of adequate care in rural and poor urban areas, and the persistence of barriers to health care, suggest the need for an integral reform rather than the partial measures (based on the assumption that improved regulation would ensure access) already adopted.

- A unique public system should be put into place, with integration of funding and health insurance, that is more equitable and easier to manage and regulate.