Managed care is an health care industry (read: insurance cos.) designed model that is supposed to hold down costs. Part of the idea (which I agree with) holds that costs are better controlled when patients have ready access to routine care--thereby avoiding very costly untreated illnesses. The $10 co-pay, for example, derives from this.
Because the model is dollar driven (and assumes the participation and profits of the middle man), it doesn't take into account the larger health care picture from a public perspective.
I trust most doctors make decisions with the health care of their patient as the primary concern. I trust most patients are at the doctor's office because of real concerns over their health. I don't assume gov't is corrupt or inefficient.