Dr. Sabins Introduction: This column will address clinical, managerial, and ethical issues in the rapidly evolving area of managed care. Forpurposesofthecolumn, the term "managed care"—which is used so broadly that it verges on losing all specificity—will refer to systems in which adeflned population receives its dinical care under a specified budget with clear accountability for clinical and financial results. By this definition, managed care occurs in all sectors-public, not-for-profit, and private. As indicated in the credo that follows, the fundamentaipremise of the column is that managed care can be conducted in a clinically and socially responsible manner. The column will approach managed care in a spirit of quality improvement by seeking to present examples of constructive developments in the field.