The Bulletin on Aging & Health

The existence of racial disparities in medical treatment and health outcomes is well known. A recent comprehensive study by the Institute of Medicine concludes that "only a handful of the hundreds of studies reviewed here... find no racial and ethnic differences in care." (1) The study notes that racial differences could result from differences in access to care, socioeconomic or geographic factors, or racial differences in preferences of patients or attitudes of providers,...

In the 1980s and 1990s, there was a dramatic shift in employer-provided health insurance from traditional fee-for-service plans to managed care plans - by 1999, 91% of covered employees were enrolled in a managed care plan. The Medicaid and Medicare programs, which together account for nearly $500 Billion in annual spending and 75 million beneficiaries, have also moved to adopt managed care - currently, over one-third of the beneficiaries of the two programs are enrolled in...