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Michael's question is good - what alternatives can one recommend?<br>
<br>
I have worked in mental health for 30 years and done most of my own
billing and insurance work. I find government programs are always the
worst to deal with, and the additional problem, Michael, is that they
are a monopoly. Both Medicade and Medicare have this impossible
quality, and I think that quality suffers when government meddles. I
resigned from a local panel with about 40% of the local population
because they were difficult to deal with. I cannot do that with
Medicare. If I want to make my living by only working on panels that
treat providers and clients with respect I can do that. Hence my fear
of government monopoly. <br>
<br>
I recommend . . . (drum roll, please) Health savings accounts for all
people. This means personal ownership. It is your money, and you can
shopt around. A friend of mine did just that. She and her husband had
high deductable insurance, and when he needed an appendectomy, she
called a half dozen providers and chose the cheapest one. Guts! But it
worked out well. The cheap provider was an older surgeon with less
overhead and less need for materialistic phallic symbols. He did a good
job on my friend. <br>
<br>
With the no-deductable plans today, there is no incentive to do that.
HMOs and prepaid plans can be very good (Kaiser seems to be excellent)
but if I had only one answer, I would say HSAs. <br>
<br>
Complete medical coverage has been a perverse incentive. It raises
costs. Why should pharmaceutical companies compete when patients do NOT
shop on the basis of cost? (Well, I always do, but most people don't).<br>
<br>
Hope that helps advance the dialog, Michael.<br>
Lynn<br>
<br>
Michael Christopher wrote:<br>
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<pre wrap="">I fear government enforcing this excellent idea,
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<pre wrap=""><!---->since I work in health care, and government in health
care is always a disaster.<<
--What alternatives do you recommend? I'm not
convinced that business in health care is any less
bureaucratic than government. Business culture, at
least when a few large corporations dominate the
market, seems to have some of the same problems as
government culture. The assumption that the market is
the friendlier force is often detached from an actual
comparison between people's experiences with
government and with business... those who have the
money to pay for good service (money does talk) are
often isolated from what others experience lower down
on the ladder, and they don't always realize the
consequences of making drastic changes in the system
because they are insulated from the effects of those
changes, beyond reducing their own taxes. For many of
the wealthy, as long as their own tax rate goes down,
everything's great. They don't always mingle on a
daily basis with people who don't have the same
resource, and it produces a lag time in the feedback
network that makes a society capable of reaching
balance. Ideally, those who make changes in a system
will be tapped into all levels of that system, and
respond to realtime feedback. Ideally, those who vote
for changes should have at least some contact with
people most affected. That isn't always the case.
My wife, who is from Australia, keeps complaining that
the large companies here don't put real people on the
phone for customer help and give people the runaround.
She feels Australia does better. She can be a little
patriotic about Australia, but then my mom says the
same thing and she's lived here all her life.
Corporations are not always less bureaucratic and
alienating than government, and there can be just as
much red tape, from what I've seen.
Michael
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