Prepaid Group Practice Medical Care Plans

Abstract

T HERE is an inexorable trend toward services for the American public. In fact, the trend toward more is evident throughout the field. It is apparent whether we look at needs or demands, services or capabilities, not to mention dollars. This trend offers both an opportunity and a challenge for prepaid group practice medical care plans to improve and extend comprehensive services. This discussion describes some of the administrative problems that arise in starting and carrying on direct service prepaid group practice. Group medical services are increasing in response to a growing demand. A compelling force toward services is the steadily growing conviction that medical care is a social right. Our high standard of living and our increasing awareness of the capabilities of modern medicine foster the growth of this conviction. The day is approaching when society and its institutions will be held morally responsible for the availability of life-saving and health-restoring Means (1) argues that the pursuit of is the of every citizen. August (2) points out that this has the same kind of justification as do the other so-called rights of man. They are rooted in our almost religious feelings about individualism and individual worth. It is only a short step from the right to health to the right to medical care. Placing in the category of the rights of man involves the transformation of a social desire into a moral imperative. The educated desire for services coupled with the economic capability of paying is accompanied by a demand for efficiency and quality control of the expanded, costly product. Not only the consumers as individuals and as organized in cooperatives, labor unions, and the like, increasingly demand comprehensive care with quality controls. Management, which as a result of collective bargaining is assuming financial responsibility for increasing proportions of the personal care bill, is also insisting and on efficiency, quality, and cost controls. Prepaid group practice is becoming ever widely recognized as an effective method for achieving these ends. The economies, for example, in hospital use among populations served by prepaid group practice, are documented.