Not just for bureaucrats anymore - Bureaucrat bashing, overhead democracy,and managed care

Managed care is increasingly subject to political micromanagement and to at tacks in the press. Managed care is undergoing the kind of bureaucrat bashi ng familiar to government employees, because managed care plans are being a sked to perform the same type of allocation of social resources (in this ca se, access to health care) typically conducted by government employees. In so doing, managed care has run afoul of two deeply ingrained American tradi tions: bureaucrat bashing and overhead democracy. This article uses a case study of managed care bashing to argue that private interests who perform a role in allocating social resources will be subject to the same type of cr iticism government employees face in allocating social resources (bureaucra t bashing), as political leaders' impulses toward control (overhead democra cy). The ombudsman model of governing managed care is advanced as an altern ative to managed care bashing and overhead democracy.