The European systems of health care developed at a time of „cheap“ medicine as social systems. These systems distribute reliably allowances according to rules set in advance but have a limited capacity of adaptation to environmental changes. Their static character was manifested in the last three decades when attempts to resolve the increasing controversies between needs and limited resources led to a series of reform processes. The temporary effectiveness of traditional regulatory and controlling tools led to demands for a dynamic system of health care capable of self-regulation. The effectiveness of allocation and use of resources of such a system will be the result of a dynamic equilibrium satisfying the interests of all subjects participating in their allocation. The volume, structure and quality of provided health care then will depend on the interaction of informed and motivated subjects and not on defined norms. Managed care corresponds to the demands laid on a dynamic health care system and proved useful in the United States. Its principles can be applied in a European cultural and legislative setting and in the majority of European countries nowadays projects of managed care are tested. Managed care enters Czech health services steadily and non-forcibly and within the near future it has a chance to increase its effectiveness in a substantial way.

        Key words: managed health care – managed care – allocation of resources – reform of the health services – dynamic equilibrium