Valley Commentary : Managed Care Can Cure the System’s Ills : Bashing the popular mode of medicine for its cost constraints has become fashionable. But it provides oversight, freedom for doctors and high-quality, life-saving services to patients.

Recently, there has been a lot of bashing of managed care, focusing on its efforts to control costs.

Much of the criticism is not fair. While managed care does seek to control costs, there is much more to it than dollars and cents. As a physician, I am here to tell you that managed care saves lives.

In the medical group of which I am a member, a suggestion by a managed care company that we contract with helped us implement a system for tracking the results of mammograms. We noticed that at one hospital we worked with, tests were conducted improperly and results were difficult to read. We changed hospitals, paying more but making early detection of an unexpectedly large number of breast cancers. Early detection means a higher recovery rate. Two years after the change there have been no mistakes in diagnosis.

In my 10 years of practice as a private family practitioner, I have had considerable experience with managed care. Approximately 75% of my practice is currently made up of health maintenance organization patients.

I have witnessed a major evolution in how managed care companies approach health care. More competition among companies has led to more interest in quality and service. Quality care, in the long run, costs less.

How is quality judged under a fee-for-service system? No entity tracks the results of doctors’ treatment plans.

Managed care provides this service. The managed care companies that I contract with track my performance and that of my colleagues. They review my patients’ charts. They insist on documentation.

They function much as a business consultant. They do not interfere with my ability to make decisions for my patients. Rather, they provide advice that allows me to provide my patients with more assurance of quality care and service.

The National Committee for Quality Assurance, an independent nonprofit institution that reviews and accredits managed care organizations, and the development of Health Employee Data Information Service “report cards” for doctors are among the tools that the managed care industry is developing.

Managed care does not limit my decision-making ability as a doctor. It enhances it. I am a coordinator of care, ensuring that my patients receive the highest quality of service.

Over the years, I have become increasingly involved with managed care for several reasons. One reason is that under the fee-for-service system, 20% of Californians had no health care coverage. Care was unaffordable, and there was a severe lack of quality monitoring.

Managed care addresses these concerns and allows me to concentrate on providing the quality of care that I was trained to provide. Managed care focuses on preventive care and reducing unnecessary services. It seeks to lower costs, which means more access for more people. HMOs immunize children at twice the rate of indemnity plans, screen 2 1/2 times more women for breast cancer, provide annual physicals and routinely offer health education programs.

Another reason for my increasing involvement with managed care is that more of my patients are choosing managed care health plans. Nearly 11 million Californians, 35% of the state’s population, belong to HMOs. In a 1992 nationwide survey of 90,000 consumers by the National Research Corp., a higher percentage of HMO participants said they were satisfied with their health plans than those with traditional plans.

Managed care is the future, a future filled with the promise of higher-quality care, lower costs and more access.