Trusting in the future: the distinct advantage of nonprofit HMOs.

Managed care's success in improving the health status of communities can be directly attributed to the not-for-profits. Three of the major organizations-Harvard Community Health Plan, Kaiser Permanente, and Group Health Cooperative of Puget Sound-in this category have participated in the critical public policy debates of the past 30 years, have conducted and funded data-based research, and have trained numerous U.S. primary care physicians for practice. An emphasis on health, rather than profits, has led tham to favour community rating. Not-for-profits have created an environment that encourages good relationships between patients and professional caregivers. They have discovered that delivering superior care is the most effective way to control costs, and they have done this while fostering partnerships with organized labor. It is critical for the not-for-profits to communicate their obvious advantages to the general public in order to ensure their survival.