Health Maintenance Organizations and the Rationing of Medical Care

Most evidence indicates that the poor in HMOs utilize services to about the same extent as do middle-class enrollees. Early experience in California, however, cautions that abuse can result in substantial underservice, fraud, and poor quality; appropriate incentives and safeguards must be incorporated in public policy. Increased competition in medical care delivery may lead to improved efficiency, but it may also lead to increased emphasis by both HMOs and other insurers on selective marketing, experience rating, cost shifting, and other practices with adverse consequences for the poor, the elderly, women, and the sick.

Author(s): Harold S. Luft

Download the Article

Read on JSTOR

Volume 60, Issue 2 (pages 268–306)
Published in 1982