1.   California leads the nation in shifting to managed care, with San Diego County in the vanguard.

2.   He observes that managed care companies have simply responded to employers who pay health benefits and want to cut costs.

3.   Under managed care, the insurer paying the bills also monitors and limits the use of medical services.

4.   And managed care now requires more managed care, a euphemism for rationing.

5.   And they are still seeking court rulings on charges that managed care practices violate other laws.

6.   And what began as a simple malpractice claim has grown into the first direct challenge to managed care to be accepted by the U.S. Supreme Court.

7.   At the same time, they are being squeezed by the drastic reductions in payments that have resulted from the changeover to managed care in recent years.

8.   Academic health centers are the sacrificial lambs as we enter the new area of HMOs and managed care.

9.   Against the backdrop of rising drug costs, managed care companies are fighting back with a variety of tactics, including one pioneered by Avorn.

10.   Both studies confirmed the suspicions of many lawmakers and senior advocates that Medicare beneficiaries in rural communities are at a serious disadvantage when it comes to managed care.