Prepaid group practice medical care plans

T HERE is an inexorable trend toward more health services for the American public. In fact, the trend toward "more" is evident throughout the health 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 health 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 more health 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 care. Means (1) argues that the "pursuit of health is the right of every citizen." August (2) points out that this right 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 health in the category of the rights of man involves the transformation of a social desire into a moral imperative. The educated desire for more health services coupled with the economic capability of paying more is accompanied by a demand for efficiency and quality control of the expanded, more 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 health care bill, is also insisting more and more on efficiency, quality, and cost controls. Prepaid group practice is becoming ever more 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.