Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Fear of Death, one salient quote

Fri, 2012-09-28 17:18 -- fitdoc

"Perhaps the best cure for the fear of death is to reflect that life has a beginning as well as an end. There was a time when you were not: that gives us no concern. Why then should it trouble us that a time will come when we shall cease to be?  To die is only to be as we were before we were born." – William Hazlitt, essayist (1778-1830)

Cost Containment's Chilling Effect

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A NY Times essay laments the underpayment of primary care and how that frustrates a medical practices best efforts.   To set the stage for this discussion, please see:  See "Eyes Bloodshot, Doctors Vent Their Discontent" by S. Jauhar, MD Pub. 6/17/08.  I was referencing that in I piece I wrote for HCPLive.com, "The Chilling Effect of Cost Containment." (Published Online: Monday, June 23, 2008.)

Duh! Better Health Insurance Coverage; Better Health Care and Results

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Much of the work on health disparities and inequities in access focuses on comparisons between the insured and those without coverage; the uninsured come out wanting.  [Surprise] “Uninsurance is associated with mortality.” Uninsured persons have less access to services and suffer worse health outcomes than those insured. Breast Cancer patients suffer with a 30-50% higher mortality rate Accident victims have a 37% greater mortality rate (1)

Comparative-Effectiveness Research (CER)

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Increasingly, the cost of care is unnecessarily dear, rising exponentially while the return on investment is falling precipitously. What can be done about improving the value of health care?

The Way To Fix Health Care

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Increasingly, the cost of care is unnecessarily dear, rising exponentially while the return on investment is falling precipitously. What can be done about improving the value of health care? Our health care system is particularly inefficient and, for some it has become unaffordable. As for the quality of care, by any measure it is variable at best.  But, why is it so hard to fix our health care system.

Insurers Eat Reform; It's Sort of Their Prey

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Insurers are in the cat-bird seat for now In the debate about health care reform, it was emphazized that to cover the under- and uninsured, the healthy escape from the risk pool; this raises the per capita cost of coverage of those who are left.  Rate increases are bubbling up all over the country; people are being pressured into buying increasingly expensive health insurance that there is good reason to believe wouldn't be there when it is really needed.        

Managed Care Organizations Practicing Medicine (Without a License)

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Aetna refused to pay for a visit of a child with a probable goiter and strong family history who needed diagnostic lab tests—they do not accept rule-outs.  Last week Oxford levied a $50 deductible and $25 co-pay for the most efficacious eardrop we have in our armamentarium; Reason? This drop, containing an antibiotic and a steroid was not available generically; they were forcing me to use a plain ear drop – not what the doctor ordered! Mental Health Parity; Let the HMO's Be Damned!

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