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Throughout the United States there has been an overwhelming concern as
to the status of the present health care system. Approximately 100,000
people lose their health insurance each month. Unfortunately the present
system does little to nothing to aid these people. It is for this reason
that various managed health care plans have come into existence and use.
Managed health care is a system by which an outside body, such as a state
or federal government places regulations on the health care process.
St. Luke/ Roosevelt Hospital in Manhattan is currently operating under
a managed health care plan. Vickie Powell, In-patient Pharmacy Supervisor
at St. Luke/ Roosevelt states that the approach to managed care in the
hospital involves a "Gatekeeper" mechanism. According to Powell each
patient is assigned a gatekeeper, a general practitioner who will decide if
the patient is in need of a specialist. If so the gatekeeper will make a
referral to a specialist. Providing the patient chooses to follow the
gatekeeper's referral he or she will be granted the health care benefits
covered under the managed health care plan. If they are to go against the
referral and see a doctor not recommended they do not receive the coverage
that they would under the plan.
When asked how this would affect the pharmacy aspect of the hospital
she said "...
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