In Austin, he met a young mother whose managed-care provider refused to cover physical therapy for her developmentally disabled toddler.

Her managed-care provider, Group Health Insurance, didn't cover a longer stay.

At the time, exhausted from delivering, she felt helpless in the face of a strict routine dictated by managed-care providers.

Some managed-care providers, however, are resistant to the concept.

Many of the nation's 5,000 health plans, trying to control surging medical costs, began to send their people to managed-care providers like health maintenance organizations.

The sponsor would negotiate with private managed-care providers, like health maintenance organizations, to offer everyone basic coverage at no additional cost.

The system would be managed because sponsors would contract with health maintenance organizations or other managed-care providers, which can offer quality care at affordable rates.

For most plans, the city will pay monthly per-capita fees to managed-care providers that equal about 95 percent of what patients' care now costs.

Now, managed-care providers are pulling out of Medicare in more than half the states (front page, June 3).

Fears about sufficient capacity of the managed-care providers is a concern of the county as well.