New Book Provides Blueprint for Maximizing Humane Services

Managed Care is Here to Stay -- So How Do We Make It Work?

Americans have made clear their feelings about the state of health insurance today through the epithets they've adopted for the term "managed care." "Damaged care," "MIS-managed care," and "managed cost" are some examples.

Anita Lightburn and Gerald Schamess, dean and professor, respectively, at the Smith College School for Social Work, state their position with a single piece of punctuation: a question mark.

Humane Managed Care?, the newly released book edited by Schamess and Lightburn, brings together research, case studies, and scholarly articles by 62 of the country's leading human service experts to consider whether managed care -- the system under which 90 percent of all Americans will receive health and mental health care by 2000 -- can ever be more than an oxymoron.

"Many, if not most human service professionals have traditionally been committed to humane service delivery," Lightburn points out. "The provider system's commitment is to 'sufficient' service. The drive for increased profitability. however, seriously jeopardizes humane care and eliminates the possibility of universal coverage.

"The implication is that the most vulnerable populations -- children, the elderly, the chronically ill, and people of color -- will have little or no care."

"One thing that's clear," Schamess adds, "is that humane care in the managed care system is conditional. It depends on your diagnosis, your category, your access to well-funded provider networks, and many other factors."

"It's not surprising that both Republicans and Democrats are proposing legislation to empower patients and clients and level the playing field."

The book, described as a state-of-the-art sourcebook on the current policies, controversies, clinical knowledge, case studies, and research strategies on managed care practices, includes articles on such topics as "Corporate Values and Managed Health Care: Who Benefits?"; "Privatization and Mental Health in Massachusetts"; "How Social Workers Can Manage Managed Care"; and "Managed Care, Mental Illness, and African Americans." The contributors are social workers, psychiatrists, psychologists, policy analysts, case managers, professional educators, and researchers.

In addition to Lightburn and Schamess, Smith contributors include Susan Donner, associate professor of social work ("Field Work Crisis: Dilemmas, Dangers, and Opportunities"); Joshua Miller, assistant professor of social work ("Managed Care and Merger Mania: Strategies for Preserving Clinical Social Work Education"); and Phebe Sessions, associate professor of social work ("Managed Care and the Oppression of Psychiatrically Disturbed Adolescents: A Disturbing Example").

Review copies of Humane Managed Care are available from NASW (National Association of Social Workers) Press, Washington, DC, (800) 638-8799.