Analysis of the evolution of payment systems across countries suggests that the concept of managed care has limited applications outside of the high-income countries. the principles of governmental regulation in countries where the healthcare system is primarily public have limited applications in countries where the healthcare system is mostly private. European countries have been largely motivated at the individual level, using deductibles and copayments to moderate demand, yet the use of pooled financing that protects patients from risks also insulates them from costs. the United States has operated largely on the supply side, constraining the provider system rather than individual demand. public and private sectors in most countries are likely to converge in a blended contractual model - what is known in the United States as managed care.

Analysis of the evolution of payment systems across countries suggests that the concept of managed care has limited applications outside of the high-income countries. the principles of governmental regulation in countries where the healthcare system is primarily public have limited applications in countries where the healthcare system is mostly private. European countries have been largely motivated at the individual level, using deductibles and copayments to moderate demand, yet the use of pooled financing that protects patients from risks also insulates them from costs. the United States has operated largely on the supply side, constraining the provider system rather than individual demand. public and private sectors in most countries are likely to converge in a blended contractual model - what is known in the United States as managed care.

		the concept of managed care has limited applications outside of the high-income countries.
		the principles of governmental regulation in countries where the healthcare system is primarily public have limited applications in countries where the healthcare system is mostly private.
		European countries have been largely motivated at the individual level, using deductibles and copayments to moderate demand, yet the use of pooled financing that protects patients from risks also insulates them from costs.
		the United States has operated largely on the supply side, constraining the provider system rather than individual demand.
		public and private sectors in most countries are likely to converge in a blended contractual model - what is known in the United States as managed care.