Economic determinants and managed behavioral healthcare: Marginalization of providers and restrictions of services

Abstract

Managed care organizations tend to prioritize finance management over services and, as a result, have alienated providers and diminshed the service delivery system, while profiting handsomely. The managed care strategy of cost-containment is examined as it relates to quality of care, particularly in behavioral health treatment. The problems of excessive manged care profits and administrative overhead are considered in relation to a pattern of misuse of limited healthcare resources. Managed care policies and procedures that reduce healthcare to a commodity are critiqued. The essay's key points for improving healthcare, in whatever systems evolve, are to de-emphasize "commerce" and to resuscitate preferred cultural values regarding "service". Suggestions for reform are made that reflect inclusiveness from a wide range of constituents in healthcare and participatory management principles to redress the imbalance of authority that now rests with managed care organizations.