레이블이 Patient Care인 게시물을 표시합니다. 모든 게시물 표시
레이블이 Patient Care인 게시물을 표시합니다. 모든 게시물 표시

2013년 11월 28일 목요일

About 'cheap health care providers'|Federal Government Encourages Health Providers to Coordinate, Then Sues Them For Doing So







About 'cheap health care providers'|Federal Government Encourages Health Providers to Coordinate, Then Sues Them For Doing So








A               Flawed               Debate               
               Listening               to               the               health               care               (finance)               reform               coverage               in               the               news               media               is               a               lot               like               visiting               from               Mars.

Politicians               and               newscasters               describe               systems               that               simply               do               not               function               in               the               manner               they               describe,               their               "fixes"               will               not               work,               and               they               usually               cause               more               harm               than               good.
               
               How               this               all               came               to               be               is               an               intriguing               story               of               lost               opportunity,               political               deal               making,               and               the               triumph               of               dogmatism               and               ideology               over               rationality.

I               explain               a               lot               of               the               flaws               in               my               book:               Standard               Errors:               Our               failing               health               care               (finance)               systems               and               how               to               fix               them               which               is               available               at               www.afn.org/~mathstat/.

The               following               thoughts               are               glimpses               of               the               implications               of               our               changing               health               care               (finance)               systems,               explored               in               the               book.
               
               Health               care               finance               -               What               is               Really               Broken?
               Over               the               last               few               decades               we               have               created               ever               more               inefficient               health               care               (finance)               systems               even               as               politicians               have               jumped               on               the               bandwagon               of               greater               efficiency.

In               the               name               of               efficiency               our               national               leaders               have               increasingly               placed               health               care               providers               and               patients               at               risk,               eviscerating               our               health               insurance               system.
               
               In               place               of               genuine               health               insurance,               they               gave               us               inefficient,               wasteful,               and               fraudulent               managed               care               systems               that               do               not,               and               never               could               deliver               on               their               lofty               promises               to               steer               our               health               care               (finance)               systems               toward               greater               efficiency.

(See               my               book:               Standard               Errors:               Our               failing               health               care               (finance)               systems               and               how               to               fix               them               which               is               available               at               www.afn.org/~mathstat/.)
               While               paying               lip               service               to               extending               health               insurance               for               all,               our               leaders               have               compromised               the               health               insurance               market.

But               the               situation               is               very               different               than               described               by               policy               makers,               politicians,               economists,               actuaries               and               pundits.

The               destruction               most               of               them               describe               is               the               exact               opposite               of               what               has               really               happened.
               
               What               Insurance               Is               and               Is               Not
               The               biggest               problem               is               that               most               people               confuse               legitimate               insurance               mechanisms               and               pre-paid               care               mechanisms.

We               lose               sight               of               the               fact               that               managed               care               and               most               of               their               solutions               for               financing               health               care               do               not               rely               on               legitimate               insurance               mechanisms               at               all.
               Four               decades               ago               we               had               a               vibrant,               growing               health               insurance               sector.

Ever               more               Americans               were               being               covered               through               their               employment               and               the               Medicare               and               Medicaid               programs               extended               health               insurance               to               the               elderly,               disabled               and               economically               disadvantaged.
               
               Costs               however,               were               also               rising.

As               people               made               more               use               of               preventive               health               care               services               they               lived               longer               and               generally               healthier               lives.
               
               The               answer               Richard               Nixon               promoted               was               to               convert               our               mixed               profit               and               profit               making               health               care               system               to               a               profit               making               system.

In               particular,               Federal               legislation               began               to               vigorously               support               health               maintenance               organizations               and               "Managed               Care."
               Despite               initial               enthusiasm               for               HMOs               and               managed               care,               they               are               not               legitimate               insurance               mechanisms.

The               rhetoric               was               excellent,               focusing               on               improving               the               health               of               the               population,               creating               an               efficient               health               care               system,               and               reducing               costs.

The               reality,               however,               was               exactly               the               opposite.

Falling               health               care               status,               an               inefficient               health               care               system,               and               increased               costs.

Rather               than               admit               that               it               has               been               managed               care               and               capitation               that               caused               many               of               these               problems,               the               advocates               of               these               failures               blame               the               ever               dwindling               legitimate               health               insurance               mechanisms               for               these               problems,               suggesting               that               if               we               simply               move               to               a               completely               managed               care               mechanisms               all               these               problems               will               go               away.
               
               If               you               believe               that               line,               I               know               some               people               selling               bridges               and               tunnels               in               NYC.
               
               What               HMOs               are               supposed               to               do.
               The               ideal               case               for               HMOs               is               that               they               will               keep               people               healthy,               hence               the               name               "Health               Maintenance."
               
               The               reality               is               that               as               we               age,               we               increasingly               suffer               from               poor               health.

The               age               at               which               we               become               chronically               or               acutely               ill               may               be               delayed,               but               it               can               never               be               eliminated.
               Health               insurance               covers               rare               but               high               cost               health               services.

HMOs               and               Managed               Care               spend               most               of               their               resources               providing               routine,               highly               predictable               care.

Since               HMOs               and               managed               care               organizations               offer               their               plans               for               less               than               the               costs               of               real               insurance,               but               spend               significant               portions               of               their               revenues               on               costs               that               are               common,               they               cannot               afford               to               pay               their               subscriber's               expenses               when               they               require               expensive               care.

Take               in               $4,               spend               $3               on               cheap               office               visits               and               preventive               care               and               you               will               not               be               able               to               spend               much               money               on               your               subscriber's               rare,               but               expensive               needs.
               
               The               Perils               of               Health               Care               Intervention
               As               HMOs               have               matured               they               have               been               burdened               by               their               successes:               increasing               numbers               of               chronically               and               acutely               ill               members               who               are               living               longer               with               multiple,               costly,               and               increasingly               treatable               illnesses.

The               calling               card               of               HMO               success               is               that               we               have               more               older               and               sicker               people               than               we               would               have,               had               if               we               had               not               been               so               successful               in               our               past               preventive               health               endeavors.
               1n               1971,               a               55               year               old               man               who               had               a               heart               attack               on               a               golf               course,               would               probably               have               died               en               route               to               a               hospital.

That               same               man,               in               2011,               will               like               survive               sudden               cardiac               arrest               and               live               for               another               20               years,               incurring               health               care               costs               for               his               post               cardiac               care               and               myriad               other               illnesses               and               accidents               during               that               20               years.
               
               Rather               than               dying               at               55               he               will               live               until               age               75,               incurring               costs               for               skiing               accidents,               cancer               treatments,               multiple               cases               of               influenza,               and               multiple               bouts               of               pneumonia.

After               20               more               years               of               additional               health               care               services               and               costs,               our               75               year               old               will               likely               have               spent               months               receiving               very               costly               care               in               hospitals               and               nursing               homes,               incurring               even               more               costs               as               his               health               continues               to               fail.
               
               Cost               for               55               year               old               man               to               die               on               a               golf               course?

$0
               
               Cost               for               55               year               old               man               to               not               die               on               a               golf               course,               live               an               extra               20               years               with               multiple               health               care               problems?

Hundreds               of               thousands               of               dollars.
               
               Where               exactly               are               the               savings?
               While               physicians,               nurses,               and               academicians               suggest               that               early               intervention               saves               money,               the               truth               is               exactly               the               opposite:               Early               intervention               increases               lifetime               health               care               costs.

The               modest               savings               achieved               by               preventing               a               heart               attack               or               lung               cancer               at               55               are               dwarfed               by               the               increased               costs               associated               with               an               additional               20               years               of               health               care.
               HMOs               that               continue               to               cover               their               increasingly               aged               and               debilitated               patients               have               to               charge               more,               not               less,               for               their               services               as               these               patients               age,               precisely               the               opposite               of               what               we               are               being               told               will               occur.
               Health               Is               Preferable               To               Illness               -               It               Is               How               We               Pay               For               It               That               Counts
               
               It               would               be               easy               to               dismiss               these               concerns.

It               is               obvious               that               all               of               us               want               to               live               healthier,               longer,               more               satisfying               lives.

We               should               all               get               the               preventive               care               we               need.

The               issue               is               not               whether               to               get               this               care               but               how               to               finance               it.
               
               We               all               use               light               bulbs               at               home               and               work.

But               we               do               not               buy               insurance               policies               that               pay               for               new               light               bulbs               when               ours               burn               out.

Why?
               Insurance               is               an               inefficient               approach               to               financing               replacement               light               bulbs               because               everyone               has               to               replace               light               bulbs.

Saving,               or               budgeting,               for               light               bulbs               makes               a               lot               more               sense               than               buying               insurance               because               we               don't               have               to               pay               an               insurer's               expenses               for               processing               light               bulb               claims               on               top               of               the               costs               of               the               light               bulbs.
               
               Suppose               a               light               bulb               costs               $1               and               lasts               a               year.

Go               to               the               store               and               buy               a               light               bulb               for               $1               and               you               are               done.

But               most               insurers               have               expenses               that               account               for               15-35%               of               their               claims               costs.

Sales               people               are               paid               commissions               or               salaries.

Insurers               pay               for               clerical               staff               and               administrators.

They               also               pay               for               office               space,               phones,               electricity,               taxes               and               other               expenses.
               
               To               buy               an               insurance               policy               to               pay               for               replacement               light               bulbs               we               would               have               to               pay               about               $1.33               for               each               bulb               we               are               insuring,               per               year.

It               is               more               expensive               than               it               is               worth               to               pay               for               things               that               we               know               we               all               need.

The               same               is               true               with               health               insurance.

Routine               office               visits,               routine               tests,               and               routine               medications               that               we               all               need               cannot               be               efficiently               covered               by               insurance.
               
               On               the               other               hand,               tornadoes               that               destroy               homes               are               relatively               rare.

All               of               us               can               buy               tornado               insurance               pretty               cheaply               because               very               few               of               us               are               going               to               actually               have               tornadoes               destroy               our               homes.
               
               Managed               care               organizations               waste               their               premiums               on               routine               costs               and               they               don't               have               the               money               to               cover               rare               but               expensive               treatments.

This               is               why               people               with               managed               care               plans               are               told               to               wait               for               care,               or               are               denied               care,               while               the               same               person               with               a               real               insurance               plan               can               get               care.
               To               build               more               efficient               health               care               (finance)               systems               we               need               to               stop               making               the               same               mistake               over               and               over               again.

We               need               real               insurance,               not               more               managed               care.









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  • Related blog with cheap health care providers





    1. rolanddarbystattler.blogspot.com/   10/03/2011
      ... US INTO TORT REFORM CAPPING DAMAGES OUR COSTS OF HEALTH CARE PROVIDERS IN TEXAS ARE SOOOO CHEAP!!!!. ITS PRACTICALLY FREE TO GO TO THE HOSPITAL OR DOCTOR IN TEXAS. THANKS GOVERNOR...
    2. thinkprogress.org   01/09/2013
      .... Health providers often see good ...James Doulgeris, a health care business and ... often the cheapest option for healthy people...
    3. pediatricinsider.wordpress.com/   05/23/2011
      ...itself actually employs the health care provider? Every dollar spent on you...likely to order the best medicine, or the cheapest medicine? How about those blood...
    4. conhomeusa.typepad.com/therepublican/   01/14/2011
      ...sell simplicity . The problem with Republican health care proposals has always...across state lines, and so on). "Cheaper, better insurance" should be the...
    5. reason.com/blog/   08/22/2011
      ...that coordinated care would make health care cheaper, integrated health networks afford providers new market power that in some cases can...
    6. prairieweather.typepad.com/the_scribe/   08/26/2009
      ...Because it you can pay for health insurance, you can get it -- or... that it's cheaper and it's fairer to...the same access to the same care at the same price. NPR : But...
    7. dumpbachmann.blogspot.com/   07/21/2009
      ... plan will be 30 to 40 percent cheaper. This action will collapse the private health insurance market, and then the Federal Government will own the health provider game.
    8. theyenguy.wordpress.com/   11/16/2011
      .... Italian banks have increased their reliance on the ECB for cheaper funding since the summer as Italy was sucked ever deeper...
    9. lyismama.blogspot.com/   05/05/2011
      ... the best health insurance simply because of the m care health insurance can still find cheap health coverage providers also give you around the florida individual health insurance coverage...
    10. hotair.com/   03/20/2012
      ...cheap. Again, I hear where you’re coming from, but we can’t make health care cheaper at the provider level when we can point to so much overhead-increasing regulation...



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