Doctor knowsbest?

Managed care has been a feature of private medicine for almost 20 years and its appeal is not difficult to understand. 'Managed' implies hard-nosed efficiency and the application of controls, while 'care' conveys a friendly sense of selfless concern for others. As a result, most insurers class all the measures they put in place for controlling cost and quality as falling within this magical definition. It is possible to see a difference between those organisations that do not think it worthwhile to challenge medical opinion before paying for treatment and those, most prominently CIGNA, th...