Throughout the United States there has been an overwhelming concern as to the status of the present health care system. Approximately 100,000 people lose their health insurance each month. Unfortunately the present system does little to nothing to aid these people.  It is for this reason that various managed health care plans have come into existence and use.
            
 Managed health care is a system by which an outside body, such as a state
            
 or federal government places regulations on the health care process.
            
 St. Luke/ Roosevelt Hospital in Manhattan is currently operating under
            
 a managed health care plan. Vickie Powell, In-patient Pharmacy Supervisor
            
 at St. Luke/ Roosevelt states that the approach to managed care in the
            
 hospital involves a "Gatekeeper" mechanism.  According to Powell each
            
 patient is assigned a gatekeeper, a general practitioner who will decide if
            
 the patient is in need of a specialist.  If so the gatekeeper will make a
            
 referral to a specialist.  Providing the patient chooses to follow the
            
 gatekeeper's referral he or she will be granted the health care benefits
            
 covered under the managed health care plan. If they are to go against the
            
 referral and see a doctor not recommended they do not receive the coverage
            
 When asked how this would affect the pharmacy aspect of the hospital
            
 she said "Pharmacy must become involved in the schooling of the patient
            
 about the medicine, where this was previously the job of the nurse."
            
 Besides this she says it would not have a great effect on her department as
            
 Managed health care plan that has received the most publicity is that
            
 of President Bill Clinton. Clinton's plan calls for universal health
            
 insurance, meaning that no one could be denied coverage.  When faced with
            
 the question of what happens to now coming into the hospital without any
            
...