Re: The healthcare thread (was Cancer:etc)

From: Brian Phillips (deepbluehalo@earthlink.net)
Date: Thu Sep 27 2001 - 15:28:54 MDT


FYI I changed the thread title cause I don't think this
sort of exchange is appropriate to a person's personal
health choices. Best to Natasha, good to hear your
winning ma'am!.

>HMOs and insurance companies could reasonably want to see monitoring
>technologies become more widespread, as a way of lowering their costs, much
>as HMOs subsidize the cost of health club memberships. Early detection can
>save them many thousands per patient in treatment costs.
Tiberius replied
<Well, why do you think they would save money? The medical profession.
like any other, charges whatever the market will bear. Tumor removal,
whether at stage 2 or stage 4, is something that even if the charges
go up, the market will not change that much.
Why would finding a tumor 2 months earlier save the insurance cos any
money in the long run? So if the hospitals/doctors can no longer get
on average 45K for a tumor because X percentage of tumors are now at
stage 2 instead of stage 4, then hospitals/doctors just increase the
price for stage 2 tumor removals. They have the money to buy
corp-gov-media and so the status quo will not change...>

Tiberius,
   Obviously you don't work in health care. I can imagine a
Health Care Administrator absolutely *salivating* at the thought
of having a stock of "insured lives" who had these sorts of
biometrics.
  Mistake #1 : The "medical profession". Incorrect. This should
read "medical professionS" (doctors and nurses), plus "allied
health care professionals" (all the techs, the audiologists, the
physical therapists etc. etc.), plus the "ancillary support personnel"
(medical social workers that sort of thing) PLUS the "straight"
administrator types (Health care admin is a huge faction, and
they run herd on all that frigging paper..gods..ugh).
  So you can't think in terms of a monolith. When you think of
doctors or similar "providers of healthcare" (clinical nurse
specialists or physican assistants) i.e. the people who "see and treat
patients" they are NOT absolutely NOT the ones writing the
bill you pay. Most of the time the fee structure is largely determined
by a complex negotiation process based on a mythical "average"
patient and an "average cost of a given procedure" and the
parties doing the dickering up in Admin are usually insurance
guys/gals (usually straight suits or beancounters) and some of
the high level social work type bureacrats (the Medicare people).
  So when you say that the "The medical profession.
like any other, charges whatever the market will bear"
 You made mistake #2.
 Mistake #2. Docters are usually not their own bosses. They work
for other people, or large companies, or else their fee structure is
essentially determined FOR them by the insurance plans and HMOs
(or the Medicare system, or the hospital coallition) and all these parties
determine their fees based on what everyone ELSE is doing.
  The system is ostentensibly set up to minimize expenditure on
patient care (and as a side effect maximizes administrative costs LOL).
So ANYTHING that generates mucho paperwork, & can be thought
to minimize the cost outlay neccessary to keep those "insured lives"
from suing in large numbers will be thoughtfully considered.
   If I am a hungry young health admin type, itching to make my
divisions fiscal year stats impressive... I'd love to have patients
with a biometric. I'd save money six different ways.
  First off I'd get Stage two tumors instead of stage 4s. Even
if the doc lost money on a simpler operation I'd gain bottom
line. Hospitalization and complication costs would be lower.
The less ICD-9 codes the MD rings up on a given casefile
the better.
  I'd likely keep them out of the hospital and keep them in
outpatient clinics more by ostentensibly providing more
"comphrensive care" (*HCA_PArthenon* Even when
your at home, HCAP is ALWAYS looking out for your
health"!!!)
  #3. Patient compliance. The "hard cases" (usually older
with multiple serious medical conditions) are notoriously bad
about taking their meds, their insulin, violating their diets etc.
Biometrics make it easier to lower ER and inpatient
costs by keeping the hard cases on maintaince regimens
outside the hospital wards.
#4. Provide more data for my physicans to use. Data is
good. Data and lots of it provide mucho ammo against
threats of non-standard care and malpractice.
#5. Patients love to worry about stuff. They also love
to feel virtous. Placebo effect. Enough said.
#6. It takes control away from physican providers. If
I'm an admin type I want as little "God-complex" as
possible for my MDs and DOs. This makes it easier
to turn the screws on THEIR paychecks next year.
simply put, anything that can be used to lower costs
will be.
And that's how it works in the real world,
cosmos help us.

Brian



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