Managed Care

Friendly Hills HealthCare Network is creating a "College of Managed Care" for its employees and those in the health care industry seeking to update their education in selected fields. Network officials said the new college is scheduled to open sometime in the summer at Friendly Hills Medical Center's headquarters on Idaho Street in La Habra. It will begin with a curriculum designed for pharmacy services management, medical office management and utilization management.

Six large managed-care companies, including California insurers Foundation Health Systems, WellPoint Health Networks and PacifiCare Health Systems, are developing a jointly operated Internet venture in an effort to reduce administrative hassles for doctors and patients and directly compete with online health service upstart Healtheon/WebMD Corp. The consortium would try to shift to the Web paperwork used in health-care transactions.

Safeguard Health Enterprises Inc. said Friday that it has completed its acquisition of a Dallas-based managed care company, and is planning another purchase. "Ideally, we'd like to see at least one more in the works by the end of the year," said John Cox, chief operating officer of the Anaheim-based health maintenance company. Safeguard is combing the Sunbelt for additional targets, he said. Cox, who's reviewing a number of candidates, said: "These things take time to pull together.

How long will people tolerate fatally restricted health care while contributing to multimillion-dollar early-retirement bonanza packages for creative ex-accountants ("Crowley Likely to Get Payout of $21 Million," Jan. 8)? Medicine has come full circle from miracles to total madness, all in the seven short years it took Mr. Crowley to help trample the once-lush landscape of available medicine in America. Ask any physician you know if making $1 million a year was ever a part of their hard-earned lives before managed care.

Dr. Daniel Ein, a Washington internist and allergist, typically sets aside two hours of office time to conduct annual physicals. He spends the first hour just talking to his patients, finding out what has been happening in their lives, looking for things that could bear on their health but that no laboratory test would detect.

Whether Americans' future health care is provided by the private managed care system or a single-payer government system, it is plain that there will be limits on what is reimbursed. But at this point much of the public does not seem ready to accept such limits. There is tremendous resistance, with people sometimes going as far as to file claims circumventing the restrictions through subterfuge.

Among the responses I've received to recent columns about the issues raised by managed care, there have been a smattering from doctors, usually requesting anonymity. A radiologist in Long Beach first wanted to go public with an account of medical insurers who, he said, are interfering with his practice. But after conferring with colleagues, he said he feared repercussions at his hospital if his name were used.

While major managed-care providers are striving, with considerable success, to keep health insurance premiums down, we see a real danger in imposing government-mandated premium caps, ("Health Insurers to Limit Premium Hikes, Experts Say," Dec. 11). The goal of premium caps is to ensure that costs are reduced, but this is fundamentally inconsistent with achieving long-term, real savings in our medical system. Virtually all health economists agree that one key to real savings is to reduce unnecessary medical treatments and provide only the services that are proven to work.

The comfortably cluttered office of neurosurgeon Brad DeLong on the Nez Perce reservation is but a stone's throw from fish hatcheries, forested hillsides and the frothy rapids of the Clearwater River. Light years away is the life DeLong left in cosmopolitan San Francisco a year ago to establish the first orthopedic practice in Orofino, a tiny, conservative logging town set amid stunning natural beauty.

With Monday's unveiling of a merger that will make PacifiCare Health Systems one of the premier players in the managed care industry, Alan Hoops can finally say he made it to the big leagues--just not the way he thought he would. The former UCLA baseball standout dreamed of a pitching career in the major leagues, and even played a couple of seasons with the West Palm Beach Expos before hanging up the glove to pursue a master's degree in health administration.