Diabetes mellitus and asthma: "twin" challenges for public health and managed care systems.

Many changes are rapidly occurring in and to health care systems in the United States. These changes reflect fundamental concerns about issues of access, quality of care, and cost of health services. The emergence of chronic diseases, the importance of economic considerations in health decisions; and the proper role of managed care organizations (MCOs) are of particular significance. Diabetes mellitus (DM) and asthma are two conditions that are frequently used as "model diseases" to study the impact of these changes. In spite of apparent differences between asthma and DM, there are, in fact, many important commonalities that explain the attention being directed to these diseases. In considering basic tenets, objectives, and approaches, MCOs and public health systems also have very common interests and characteristics. In understanding the impact of the many emerging health care concepts and approaches on DM and asthma, public health and MCOs can be better positioned not only to understand each other, but also to subsequently address other important chronic diseases, injury-related disorders, and behavioral/emotional conditions in an effective and efficient manner.