Abstract
According to the conventional wisdom, the managed care backlash was interest group politics at its worst and produced bad policy. Managed care organizations (MCOs) and the private sector, so the story goes, are not perfect, but the alternative - having legislatures manage health resources and bureaucracies make health care decisions - is even worse. Over the long run, we are told, the market will ensure that MCOs deliver high quality health care. Consumers will leave poorly performing MCOs for ones that respond to their concerns. In this essay I argue that this account misses what backlash is about. Managed care is not yet as good as it gets. It will improve as it is subject to consumer pressure. Backlash is unlikely to disappear until the industry matures and thoughtful regulatory authority protects the public, and the industry from itself.
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