Many employees must designate a health plan through their employer. These days, as HMOs (health maintenance organizations) and managed care plans continue to proliferate, that means a choice between bad and worse. As employees line up in the lunch-room for a process called open enrollment, they may be surprised to learn that managed care rates have gone up again. The mirage that managed care is cheaper care is finally fading. And, for the first time in years, employees may also have the promise of free choice in medicine in the form of a new method of financing health care. Consumers are already aware of horror stories involving HMOs, but cheap rates persuaded many that managed care is less expensive. Recent rate hikes are proving otherwise. Many patients must go out of network for crucial care. Co-payments are rising. It's little wonder why. As HMO executive Randall Crenshaw, chief medical officer for Cariten Healthcare of Tennessee, recently told the Wall Street Journal, more managed care patients are becoming "frequent fliers;" they over utilize health care and drive costs up. The deterioration of managed care stems from a basic economic principle: health care subsidized by government and rationed by bureaucrats is doomed to failure. Canada's socialized medical system, which designates knee replacement an elective, is sending patients scurrying across the border and national health care in the United Kingdom restricts heart transplants to anyone under age 55. Managed care in America is no exception. Congress made health insurance premiums fully tax deductible to employers covering employees' health care in 1942. This discouraged individuals from buying insurance for themselves and encouraged employers to offer benefits. Eventually, employees came to regard health care as an entitlement provided by the employer. In 1965, Congress created Medicare. Seniors were forced into the free-for-all of Medicare, personal responsibility was r...
