The strategic agenda for real reform lies in creating a value-based health care delivery system. As stipulated by Porter and Lee in 2013, health care will be organized and paid for differently in the near future. Six critical steps in reform as as follows [modified]: Separate primary from preventive care; reorganize care around patient medical or surgical conditions, forming what they call “Integrated Practice Units” (essentially team work);
insurance and coverage issues
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Patient or Guardian Responsibility in the Cost of Care Employers have been cost-sharing to mitigate the ever rising healthcare premium costs. Examples: HMO's/PPO's now see annual deductibles in 83% of people in employer-sponsored coverage [up from 53% in 2006], co-insurance, co-pays and, more recently 'high-deductible' Health Plans (HDHP) [In 2016, 29% of covered employees were in an HDHP, up from 8% in 2008.]
The health insurance and managed care industries are strange bedfellows. Health insurance, however, seems to work better for health insurance companies than patients, by and large. They, the insurers "like to cite figures showing that 87 cents of every dollar in premiums is spent on medical claims. But a new Senate analysis suggests that for-profit insurance companies are spending much less than that, especially for policies sold to individuals and small businesses.
"I don't understand why health care and insurance companies keep appearing in the same sentences." (Fisher, W. Truthout 10/25/09) Isn't it frustrating to have to live under employment based health care insurance? If you lose your job, your employer wants to cut back, or you are a peasant, you're screwed! Also, as a result of the way we are paid and the insurance model itself, there are many forces today that steal us away from the exam table or bedside.
A physician gets milked! Consider what happened to me....
Is U.S. Healthcare More About Money Than a Calling to Help Others?
Insurers are in the cat-bird seat for now , but.... 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.
Off the record...health care is a mess. On the record...health care is a mess. From: A State Medical Director for managed entitlement programs, Justin We're a captive audience, stuck between the proverbial 'rock and a hard place'.... Big Pharma's making our drugs the most expensive in the world and getting Congress to protect their trade; it's a quid pro quo for support and TV adds in favor of health care reform.
To restrain greedy private insurers.... A predictable result of the absence of a Public Option is the veritable shell game we are about to see perpetrated by private insurers. Do you blame them? After all, their 'medical business' (as opposed to the 'business of medicine'--health care) is threatened by reform