Il-Managed Care
I wouldn't have believed six months ago that health care reform could be derailed this time around too. However those same battle lines and largely same actors form those old lines again
Health reform can pay for itself. - By Timothy Noah - Slate Magazine. Health Care Reform stalls and degenerates into a PushmePullyou game that will ensure nothing happens for another generation. There are forces that do not want a broken and dysfunctional health system fixed. It works for them
An online guide to following the health care legislation. - By Timothy Noah - Slate Magazine. They get what they want out of it. They being: insurance companies, those running the existing HMO market place. Here lies a simple story of greed and narrow self interest. The truly wealthy (defacto opposite of your truly needy) who desire the ancient health care: on demand primary care from a particular individual who essentially functions as a retainer. This describes the old indemnity insurance models (at least in nostalgic view) and the higher-end PPOs today that emulate them. This is also those upper income segments for whom health care costs are not ordinarily a primary budget item, ie those who do not know off the top of their heads what they pay, because it just isn't critical. A $10 loaf of bread to a rich man. To a degree also, those preferring the status quo include many who have access to a decent managed care health plan through stable employment with a large scale organization and therefore feel falsely secure.
I confess to lacking the intestinal fortitude to throw my self into the middle of this angry ocean of policy
The Health Care Crisis and What to Do About It - The New York Review of Books and chew my way to shore The Treatment. (New Republic health blog). Perhaps modern medicine has something for that; intestinal fortitude in a prescription caplet. Something I could use my pharmaceutical co-pay plan for. Then I could join in on all those thrilling workplace discussions that revolve around the words: "My Meds." What I have though is only the outlook of a consumer. I am aware that with the last round of state employee insurance "Open Enrollment" I went into something that is somewhat less than an HMO (an EPO). This, though, is more that a great many others have, and more than no insurance at all. Any long-term illness; though, would overwhelm its delicate nature. And concurrent with this the insurance system would quickly divest themselves of me.
All this informs my limited notion of what a Healthcare system ought do. There are three things I might expect from a modern HC system. - Be universal or a close to it as friction allows. I noted the example President Obama used in his speech "the one individual who refuses to be covered..." compares closely with standard undergraduate philosophy arguments about the power of the state to compel inoculations against infectious diseases. Society is generally understood to have some standing here. Additional to trying to be universal it should be designed not to devolve into a two tiered system. With professional care and modern technology for the wealthy, who avoid adverse selction traps, and paraprofessional outpatient care for everyone else. The point of medical insurance is to move medical care beyond "immediate means.
- Delinked and portable. That is not tied to employment necessarily, a matter of institutional convenience. De-linked so that health no longer drags American industries down. On grounds of creating a permanent or transportable health care. Eliminating "preexisting condition" hurdles and encouraging smaller employment scenarios and entrepreneurship. A single-payer system wouldn't burden small businesses.
- Efficient and sustainable Less expensive yes, but only more so than how the current insurance company model would deliver a complete system. Costing less but doing less, isn't what should be regarded as sufficient. I do not believe that public run systems are any less efficient than private in principle. In practice, however work is apportioned: public or private, work done for a large resourced and distracted client will produce similar tendencies towards self interests and inefficiencies. Ask any private contractor with a large and semi-permanent institutional contract: General Dynamics, or Halliburton/KRB for instance. If single payer system is cheaper and more efficient I would not place any secondary valuation in its way. Health care should proactive rather than reactive. The was a large part original intent of HMOs. Managed care was never intended to be a solely gate-keeping process
Certainly I question the hostility towards health-care reform as stated. The Frontline survey of health care variety in a handful of other nations demonstrated forward thinking in nations whose free market and standard of living credentials are easily a match for our own
"Sick Around the World": PBS Frontline . "Killing" health care reform with no thought for genuine and broad societal reform, the need for but simply for the desire to hinder President Obama politically, disrupt his momentum is destructively narrow minded. Against this the future costs of not reforming the system should be levied and opinions judged.
Other forces against reform do so for the sake of a small but potent segment of American service economy the insurance industry. Which is unwilling or unable to see beyond todays dollar. They profit richly enough to have the excess wealth to influence and carry along lawmakers
Drug Firms Pour $40 Million Into Health Care Debate : NPR. Who can decide whether or not reform happens, but not what happens next.
11:46:12 PM  ;;
|
|
