managed health care, system of health-care delivery that aims to control costs by assigning set fees for services, monitoring the need for procedures such as tests and surgical operations, and stressing preventive care. Managed health-care systems include health maintenance organizations; preferred provider organizations (PPOs), networks of doctors and hospitals that adhere to given guidelines and fees in return for receiving a certain number of patients; and point of service (POS) plans, which are similar to PPOs but allow patients to go outside the network for treatment, usually at a higher cost. The term is also used to describe more traditional health-insurance plans that require that more expensive procedures be reviewed and approved by a plan official before they are performed. In managed care, the doctor is often paid a set fee or is paid a set amount monthly for each patient, a scheme called capitation. Many physicians criticize managed care systems, saying that they take away their freedom to make treatment decisions, that they are motivated mainly by economics, and that they do not consider patients as individuals. Managed health-care systems also limit doctors' incomes and what many people consider to be the abuses of the older fee-for-service system that rewarded doctors financially for doing more procedures. See also health insurance.

health-care proxy, legal document in which a person assigns to another person, usually called an agent or proxy, the authority to make medical decisions in case of incapacitation. It is, in essence, a power of attorney for health care. In many cases, the health-care proxy is used in conjunction with a living will that spells out the person's wishes regarding the extent of life-sustaining treatment desired at the end of life. It differs from a living will, however, in that the chosen agent has the authority to deal with any medical situation that may arise, not just end-of-life situations, and in that the agent can deal with circumstances not foreseen by the person in a living will. A health-care proxy gives a next of kin or other family member additional authority to make decisions; it can also be used to assign authority to someone outside the family. Health-care proxies go into effect when the attending physician determines that the patient lacks the capacity to make decisions. Prior to that time, the person retains all decision-making rights.

foster care, generally, care of children on a full-time, temporary basis by persons other than their own parents. Also known as boarding-home care, foster care is intended to offer a supportive family environment to children whose natural parents cannot raise them because of the parents' physical or mental illness, the child's behavioral difficulties, or problems within the family environment, e.g., child abuse, alcoholism, extreme poverty, or crime. Such children are usually wards of the state. They may be placed by a state-approved agency in group homes, institutions (such as residential treatment centers), or with families who receive some payment toward care. The child's parents may retain their parental rights, and the child may ultimately return home. Under permanent foster care the agency has guardianship; the child may then be available for adoption by the foster parents or others. Foster care can also provide a supervised setting for adults with mental or emotional disabilities who cannot care adequately for themselves. The concept of foster care has been extended in recent years to include care for elderly persons, on a fee basis, in the homes of people who are not family members.

day-care center: see day nursery.

CARE (Cooperative for Assistance and Relief Everywhere), nonprofit, nonsectarian federation of agencies devoted to channeling relief and self-help materials to needy people in foreign countries. Organized in the United States (1945) to help war-ravaged Europe, CARE soon expanded its program to include developing nations in Asia, Africa, and Latin America. Famous for its "CARE packages" of food and other necessities, CARE in now also involved in population, health care, land management, and small economic activity. It is now an international organization with 10 member countries and headquarters in Brussels.