What should be government's role in a market-oriented health care system?

What's the appropriate amount of regulation?

Who should regulate-states, federal government, or market forces?

What role do the courts play in this regulation?

Are there existing models that might guide leaders in designing an effective regulatory structure?

Welcome to the great managed care debate. In Regulating Managed Care, twenty-six of the nation's leading health policy experts give health care administrators, clinicians, and policy makers insight into the issues behind this critical exchange and provide leaders with a road map to assess the policy options available to protect the quality of our health care delivery system.

Six states require health plans to provide or authorize second medical opinions (SMOs). The intent of such legislation is to preserve consumer choice, to improve the flow of information, and to improve health outcomes in this era of managed care. However, it is unclear who benefits from these laws. This paper reviews the changing role of second opinions and, using a nationally representative data set from the Commonwealth Fund, examines who gets them. Of persons who had visited a doctor in the previous year, 19 percent received a second opinion, for an estimated cost of $3.2 billion in 1994. Findings suggest that cultural norms and sociocultural factors may partially determine who may benefit from SMO legislation.

By the year 2050, the population of the United States is projected to be approximately half white and half non-white. Yet the knowledge of child development within ethnic minority groups lags markedly behind knowledge of child development for white Americans, and it is increasingly clear that the rich diversity within minority groups is masked by studies focusing on between-group comparisons. Children of Color: Research, Health, and Public Policy Issues, a collection of original essays, brings together researchers from the fields of education, family and child ecology, nursing, psychology, sociology, pediatrics, anthropology, and social work to explore the rich cultural, familial, and individual diversity of all ethnic minority groups. The essays were generated by round table discussions sponsored by the Society for Research in Child Development and the Irving Harris Foundation, and they cover a broad range of topics including immigration policy, social policy, health status of immigrant infants, children and families, and educational policies related to minority children.