Issues for patient and family.

: This article explores managed care in the 1990s from the perspective of patient and family. This perspective is a complicated one because there is no one managed care program and there is even more diversity among patients and families. Four major issues are singled out for discussion: choice, access, cost, and quality of care. Also discussed are the skills needed by patients and families, as well as health care professionals, that are taking on growing importance in the managed care environment: communication, negotiation, and advocacy.