z wrote:
> Because there are no expenses for HMO marketing, competing redundant
> HMO bureaucracies (if you think the government bureaucracy is bad
> you're not familiar with HMOs), huge executive salaries, dividends and
> profits for shareholders, money to cover investment losses (a big
> factor in the current sudden rise in insurance costs, or didn't you
> know that that's what insurance companies and HMOs do with your
> money?); because providers don't have to spend significant chunks of
> their highly expensive time filling out various and sundry varieties
> of reimbursement forms; because there are no random deliberate or
> accidental routine nonpayments of bills that should be paid, requiring
> a repeat of the reimbursement process; because a huge health plan has
> the market muscle to wrestle low charges from providers, who then
> charge correspondingly more for smaller plans and charge the maximum
> for individuals paying out of pocket. (Or did you have no idea the
> discount your health plan, if you have one, gets from the amount you
> see on your hospital bill?)
> Of course, that explains why Medicare gets the lowest rates in the US,
> and is one of the most successful plans in terms of patient
> satisfaction, as well as being the only health plan in the US whose
> members get care that's at or near the top rank of the industrialized
> nations. Ironic, because of course it is, of course, state-run
> healthcare.
Don't be so sure.
" Medicare, the nation's largest purchaser of health care, pays hospitals and doctors
a fixed sum to treat a specific diagnosis or perform a given procedure, regardless of
the quality of care they provide. Those who work to improve care are not paid extra,
and poor care is frequently rewarded, because it creates the need for more procedures
and services."
.. . .
" "Right now, Medicare's payment system is at best neutral and, in some cases,
negative, in terms of quality we think that is an untenable situation," said Glenn
M. Hackbarth, the chairman of the Medicare Payment Advisory Commission, an independent
panel of economists, health care executives and doctors that advises Congress on such
issues as access to care, quality and what to pay health care providers." New York
Times 5 Dec 2003 Friday Section A; Page 1; Column 1
http://tinyurl.com/y1t7 [NY Times, no registration needed]
(According to Lloyd, the NY Times would be a right wing rag, I'm sure, lol).
Despite the problems, some don't want them fixed:
"Keep Your Hands Off Our Medicare!" -Senator Ted Kennedy (D, Mass)
>
> > >> Because all the examples we have of state-run health care say it would.
> > >> Economy of scale, negotiation for lower prices, preventative care instead of
> > >> waiting until the person becomes sick -- all these and other factors.
> > >
> > >So your answer is we would save money through the reduced quality of care.
> > >I suggest you gain some experience with how government price controls
> > >have a negative impact on care, at least with regards to how it works
> > >in the USA.
> > >
> > >
> > Again, I refer you to all the data which shows people in Canada and western
> > Europe are healthier and live longer.
>
> >And naturally this has absolutely nothing to do with lifestyle, food
> choices,
> >relative scarcity of obesity, and regular excercise as part of the
> daily
> >routine. Nope, it must only because of state run health care.
>
> Well, yeah, good to see it's dawning on you.
> The famous JAMA 7/26/2000 paper points out that the US doesn't have
> such bad habits as to put it at the bottom of the barrel for health
> care outcomes; we're the 5th best and 3rd best for smoking for females
> and males, 5th best for alcohol consumption, fifth best in consumption
> of animal fats and third best for cholesterol level, for instance. And
> deaths from unnatural causes, like getting shot or car accidents, are
> not included. So, if we rank at the bottom of healthcare measures of
> quality without ranking at the bottom for lifestyle causes, it's hard
> to escape the implication that we are just not getting the best or
> most appropriate care, regardless of price.
Japan has one of the highest smoking rates in the world (greater than US per capita),
but its smoking related diseases are lower than the US. So there are other factors
involved. The US leads the world in obesity, a country where even poor people have so
much to eat that they are overweight. Lack of exercise is also a major concern.
Fortunately both of these are personal lifestye choices for all of us that are
physically capable to do so.
> But enough about me and what I know; what evidence do you have that
> you are getting the best care in the industrialized world, or even
> average care for the industrialized world, other than your deep-seated
> belief that anything else would be just too unthinkable to even
> consider?
I know that the care I have received has been excellent and have no problems to
report. When my father needed care, his HMO provided him with a superior heart
procedure at a Boston hospital that was invented there.
