Managed Care And Fears For US Clinical Research

10 July 1997

The July 16 issue of the Journal of the American Medical Associationcarried a number of articles on the effects the changing US health care climate is having on clinical research.

A commentary on the articles by Kenneth Shine, president of the Institute of Medicine, National Academy of Sciences, says cuts in Medicare and Medicaid and attempts to control expenses through managed care are threatening the USA's leadership in health research. He says the success of US medicine is based on a policy to support basic science research, research training and education in the same institution, coupled with "a strong commitment to apply basic research through clinical studies performed during clinical care."

However, changes in funding have disproportionately affected clinical departments, he says. And while much clinical research has been accomplished while patients were receiving usual care through their insurance coverage, managed care organizations' willingness to refer patients and pay usual care costs remains in question.

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