Message from discussion Unversal Health Care FOR IRAQ but NOT FOR the USA?

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Subject: Re: Unversal Health Care FOR IRAQ but NOT FOR the USA?
Date: 28 Apr 2003 01:19:13 -0700
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karl...@yahoo.com (Karl) wrote in message news:<911abb80.0304261516.2ad2ce66@posting.google.com>...
> jep...@shell.ntrnet.net ((null)) wrote in message news:<3ea51768$1_1@news.buzzardnews.com>...
> > In article <911abb80.0304211416.25fc...@posting.google.com>,
> > Karl <karl...@yahoo.com> wrote:
> > >The case for "standards" from someone like the government is clear. 
> > >Health care and Health Insurance can get very complicated and many pay
> > >the price.  I found this on the Amercican Bankruptcy Institue website:
> > >______________________________
> > >New Study Points to Medical Bills as Bankruptcy Catalyst 
> > >Of the more than one million people who filed for bankruptcy in the
> > >United States last year, more than half of them did so at least in
> > >part because they were unable to cope with medical bills or other
> > 
> >   This is well-known Karl.  It is one of the reasons why we have
> > such cost-shifting in hospitals, for example.  However, were our
> > medical expenses not twice the average for industrialized
> > nations, it would not be such a serious problem.
> 
> 
> TWICE the average?  Seems a bit high, don't you think????

George throws this number out routinely.  It isn't correct.
 
> It's not as much HOW MUCH we spend here in the US it's how we spend
> it.
> We have little incentive to be efficient overall.  

We?  Under reimbursement schemes for inpatient care sapecifically,
there are tremendous incentives for efficiency.  Note, much
reimbursement is made on a fixed price basis - any efficiencies result
in increased profit.

> People don't care
> about the cost as long as it's covered.  

Payers care about the cost.  You argue for UC/SP and then you argue
this.  Do you see the contradiction?  Better, do you see the inherent
problem?

> Individual companies are
> ALWAYS going to focus on their own area and not worry about the big
> picture, as they should.  

By companies, are you refereing to employers responsible in part for
insurance premium payment or providers?  Under a managed care concept
the incentives for comprehensive and continuous care over ride silo
budget approaches common in Medicare and medicaid systems.

> But I think someone should think about the
> big picture.

The only possible way to incentivise this view is to put the financial
risk on the "big picture".  That is the approach taken by many managed
care organizations.