More InformationJHHSA Articles 
Creating an Ethically-Sound Model of Decision-Making by Managed Care Organizations Providing Care to Children
SUSAN ZINNER-KEMP
JHHSA, Vol. 24 No. 3,
(2001)
Managed care systems are characterized by a number of
inherent tensions. First, tension exists between the needs of
the patient and the provider who may or may not have a
financial incentive not to refer the patient for subspeciality
care. Second, tension exists between the patient and admin-
istrators of the managed care organization (MCO). Finally.
tension exists between balancing the needs of the patient
with those of the larger needs of society. Provision of care to
one patient could mean that the needs of another patient may
not be met in the future. This article will compare the
Canadian and American approaches to addressing the needs of
chronically-ill children in managed care settings and
propose criteria for making medical decisions affecting this
population.
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