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Health Plan Rankings: the numbers speak for themselves
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Date: 2007/12/18 14:50
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By: ohiomd
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Status: User
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Forum Head Nurse
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This thread discusses the Content article: Health Plan Rankings: the numbers speak for themselves
Insurance companies, Hospitals, etc want to make a profit so they can stay in business. And normally because they want to out compete other businesses, they will have a better product.
Based on the survey, this does not work with improving patient quality of care. Why?
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Re:Health Plan Rankings: the numbers speak for themselves
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Date: 2007/12/19 19:39
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By: toledo
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Forum Attending
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I think it does not work with patient care because it takes a significant investment of time to get the best patient outcomes. And that time is not reimbursed.
Any other possibilities?
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Re:Health Plan Rankings: the numbers speak for themselves
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Date: 2007/12/30 20:27
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By: jrwbsbl
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Forum Junior Resident
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For profit medical insurance is unlike just about any other health care entity because it was created entirely for the purpose of engendering profit, not out of a need for a service. Prior to 25 to 30 years ago, medical insurance was almost exclusively not-for-profit. The Blue Crosses and Blue Shields of America wwere all not -for-profit.
For-profit-hospitals arose primarily out of the environment of smaller, rural hospitals that were floundering. Humana, Inc., for example, began running and then buying these small hospitals, proving that they could survive and propser. From there, the process mushroomed and eventually Humana evolved into the massive HCA of today.
But concept was still born out of a need.
This was never true for insurance. Changing to a for-profit configuration resulted from a relaxation of regulation. When this allowed privatization of companies, no need was served other than a whomping profit for management. Specifically, patients did not benefit because an insurance company's sole function should be a redistribution of premiums.
For health insurance to offer a benefit, this function would have to be performed in a more efficient fashion. Instead--for-profit status brought more inefficiency.
Add to this the fact that for-profit companies maust generate a return on investment, and a condition is created where dollars devoted to profit and increased administrative costs take away from dollars left over for patient care.
THAT is why these companies fail to be the best. In this arena, it is impossible to serve the two masters of excellence and profit.
Jeffrey Waggoner, MD
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Re:Health Plan Rankings: the numbers speak for themselves
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Date: 2007/12/31 14:35
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By: ohiomd
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Forum Head Nurse
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Great points Jeff!
What can we do to get better quality of care, regardless of the profit status of a company?
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Re:Health Plan Rankings: the numbers speak for themselves
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Date: 2007/12/31 15:09
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By: jrwbsbl
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Forum Junior Resident
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In the short term, the insurance companies have been gifted with a hugely sloped playing field. They rank as one of the top industries for rate of return on investment because they can basically set whatever level of profit they wish. Health care is an industry that is being characterized as in crisis, but insurance companies always operate at a profit. They simply set premiums such that this is the case.
This is why free market advocates are pushing for "greater competition," but there is no data to substantiate that even in markets where there is maximum competition between insurance companies, costs are controlled to any significant degree.
Since employers determine who they will suipport with their benefit programs, we are thus left at the mercy of their choice and the quality of the insurance company that they choose.
Short term, to be quite blunt about it, we're screwed.
The answer is quite obvious, but one that America is loathe to consider. If you're really interested, go to http://stores.lulu.com/medmprph. I hate to be self-serving by hawking my book, but I am absolutely convinced it defines the only solution to the problem.
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Re:Health Plan Rankings: the numbers speak for themselves
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Date: 2008/01/02 15:18
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By: wlw
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Forum Attending
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Hi Jeff
I am interested in this topic and tried to open the link about your book but it said webpage not found. I will go the home page of the website and try to get info on your book. I will let you know what I think!
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