Medtronic suggested the managed-care provider combine its network of doctors with Definity's personal-care accounts.
Graham has overcome this problem by using only large samples of data collected by managed-care organizations.
Conversely, foreign managed-care providers are entering the region rapidly, especially from the United States.
Mothers in managed-care plans are only two-thirds as likely to be subjected to a Caesarean.
But such prudence is probably not enough to improve the finances of the managed-care industry.
The for-profit managed-care firms that force American hospitals to squeeze costs are unknown in Japan.
The possibility of selling diagnosis-and-treatment packages to cost-conscious managed-care organisations could boost the firm's sales still more.
Of the public sector's Medicare recipients, meaning most Americans over 65, 16% are enrolled in managed-care plans.
UnitedHealth's announcement is one of a number of attempts to make the managed-care industry a little more palatable.
Marketing managed-care plans to the elderly is expensive, since they must be persuaded and enrolled one by one.
The managed-care approach doesn't address the fundamental causes of why people get sick.
Mergers between managed-care firms are especially tough, because their information systems, and the policies they offer, are very different.
But with over 75% of America's privately insured employees already in managed-care plans, there are few corporate pickings left.
Whereas premiums paid to managed-care firms in America have levelled off since 1994, private medical spending abroad is growing.
One reason is simply that governments and managed-care organisations want lower drugs bills.
Aetna, an old Connecticut insurance firm, was trying to shift from low-growth financial services into the booming managed-care business.
After more than a decade, managed-care plans--with their incentives for doctors to hold down treatment costs--cover about half the population.
But Peter Kongstvedt, a managed-care expert at Ernst and Young, a consultancy, warns that this is far from easy money.
Merck explained data emphasising the drugs' cost-effectiveness to European health services and American managed-care firms, which pay a patient's bill.
Medtronic, a medical-device maker, began offering its employees this sort of plan, along with more conventional managed-care coverage, last year.
But HMO foes do think they can make the managed-care plans behave better, by methods as varied as the opponents themselves.
Some people might want to go back to a traditional Medicare plan versus the Advantage plan that works like a managed-care plan.
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And since Aetna specializes in selling managed-care plans to businesses, not government, it's not vulnerable to the coming cost squeeze on Medicaid.
Some analysts predict that the 30-odd managed-care insurers that compete today in California will be concentrated into seven to 10 by 2005.
One problem is that people in poor rural communities are unattractive clients for managed-care organisations, and may languish outside the new systems.
The government is trying to clamp down on overbilling by managed-care firms.
Medical groups, managed-care organizations and insurance companies codify and use treatment guidelines.
But UnitedHealth and Amil said they expected their combination to win approval because Amil is a managed-care firm, not primarily a hospital operator.
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KPMG, a consultancy, found that as managed-care enrolment soared between 1992 and 1996, inflation in health-care premiums fell from 10.8% a year to 0.5%.
Instead, managed-care firms have been tempted by the 37m people covered by Medicare, the federally funded health-insurance scheme for Americans over 65 years old.
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