Abstract
Managed care, sometimes called managed competition, is being advanced as the solution to the problem of soaring health care costs which have plagued the United States for at least the past two decades. Managed care involves a third party reviewer, sometimes called a case manager, to authorise the medical expenditures ordered by physicians. Managed care usually involves a capitated payment system in which a Managed Care Organisation (MCO) agrees to take care of the health needs of each head, also called a ‘covered life’, for a fixed fee.