Witness the outrageous 20-30% administrative overhead of medical insurance companies....
That includes a covert and obnoxious 'cost-savings-is-more-important-than-patient-care' reward system. This is even true for non-profits. It's the difference between medical business and the business of medicine—taking care of patients or profit$.
As stated in the Consumer Watchdog, Dec. 24, 2009, health insurers' rate increases among other intolerable, unaccountability must be monitored, if not prior-approved (cross-ref. Calif. Proposition 103).
Submitted by Nirav Patel (Link, delmarfamilymed.com/ cannot be verified) on Wed, 2010-01-06 16:14.
Another Perspective: I don't think health insurance companies are 100% EVIL (many of the rules they impose on doctors keeps them from doing crooked things and ordering extra stuff which could hurt the patient) but are so bad right now because they do whatever they want. Break the Anti-Trust exemption and force them to be more transparent and see if they can keep that 20%-30% buffer to play with. We can use the blogs to spread the word about the companies that use the least amount of money on APPROPRIATE care. Even though they spent the money, they can just give it to certain doctors on their payroll to keep the money under their control. Don't put anything past 'em'!
I agree, Dr. Patil. Here's a fundamental of managed care that is in keeping with your ideal of positive support of doctors--"Measure and Manage."
"Health care reform will eventually pit the goal of expanding health insurance coverage against strong pressure to reduce the growth in health care costs. If left to measures in the proposed reform legislation, cost containment will be driven primarily by marketplace incentives, programmatic initiatives, and organizational changes that would partially offset the costs of expanding coverage. These proposed economic policy changes and incentives, however, are not guaranteed to lead either to individual clinical decisions that will be in patients’ best interests or to enhancement of the public’s health. Rather, these forces are relatively blunt instruments that might nudge the health care system toward efficiency, without precise direction."
"Thus, to ensure that the health of the population is enhanced, rather than diminished, by the reforms, these measures must be accompanied by the sharper tools of comparative-effectiveness research (CER). Unless we are willing to allow our health care to be driven solely by financial and regulatory incentives, CER should become an important part of the equation. Rather than being resisted by the clinical and public health communities, it should be embraced."
Mushlin AL, Ghomrawi H. * "Health Care Reform and the Need for Comparative-Effectiveness Research. Posted by the N Eng J Med, Jan. 6, 2010 [* From the Department of Public Health, Weill Cornell Medical College, New York.]