Hmo: The Health Care of The BeastEssay title: Hmo: The Health Care of The BeastHMOs: The Health Care of the BeastMany people are concerned about rising health care costs. In reaction to this, some individuals and companies are gravitating toward the assumed lower prices of Health Maintenance Organization (HMO) health plans. HMOs spend billions of dollars each year advertising their low cost services. While these savings look good on paper, there are many pages of small print. The explanation after the asterisk indicates that not only do the HMOs lack lower costs, but they also short-change the patient in quality care. Much of the money spent on premiums goes directly into the pockets of stockholders and less is then available for
Hmo: How to Make Money In America’s Health Care system, the U.S. health care system looks to have been designed precisely to cost health care to individuals. Unfortunately, a significant lack of care leads to a growing number of patients experiencing significant problems with their health and/or the quality of their care.HMOs spend billions of dollars every year advertising their low cost services. While these savings look good on paper, there are many pages of small print. The explanation after the asterisk indicates that not only are the HMOs lacking lower costs, but they also short-change the patient in quality care. Much of the money spent on premiums goes directly into the pockets of stockholders and less is then available for
HMO: How to Make Money In America’s Health Care system, the U.S. health care system looks to have been designed precisely to cost health care to individuals. Unfortunately, a significant lack of care leads to a growing number of patients experiencing significant problems with their health and/or the quality of their care.
Wealthy Individuals Shouldn’t Be Creating Higher Prices because Health Care Costs Are High-Cost
Health care costs are more or less equal to what health care is offered to people with preexisting health conditions (PNHPs). People are less likely to need care when they’re older because they have fewer health coverage. According to the Congressional Budget Office, health insurance companies pay nearly three times more for health insurance to adults for their premiums, which means that there are fewer people able to afford health insurance when they reach retirement ages. The average employer makes less in the third quarter of 2009 than it did in the same time period in 2000. In this post, we’ll examine one major reason why we’ve been unable to find a clear cut replacement for health care: people need higher health care.
The Federal Healthcare Affordability and Retireability Act also made health care more accessible to high income people. According to one recent report, this change allowed those with income in excess of 50 percent of the federal poverty line to receive coverage at an affordable cost. So we can afford to give the same benefit to a family of four or a family of three, who pays $8,550 a year, for a lifetime of coverage. So why not put an extra dime into our health care system?
Health insurance companies are also less willing to cover high cost benefits than other health care providers. In an interview with Bloomberg Businessweek, Susan Glase, senior director for ACA at health care provider group Consumers Union, argued that the law has created an environment in which health care providers have a higher rate of giving up Medicaid or Medicare, even on the assumption that people who are in the best shape of their lives will benefit most. In other words, there is a premium for a doctor who gets a life insurance policy,
Hmo: How to Make Money In America’s Health Care system, the U.S. health care system looks to have been designed precisely to cost health care to individuals. Unfortunately, a significant lack of care leads to a growing number of patients experiencing significant problems with their health and/or the quality of their care.HMOs spend billions of dollars every year advertising their low cost services. While these savings look good on paper, there are many pages of small print. The explanation after the asterisk indicates that not only are the HMOs lacking lower costs, but they also short-change the patient in quality care. Much of the money spent on premiums goes directly into the pockets of stockholders and less is then available for
HMO: How to Make Money In America’s Health Care system, the U.S. health care system looks to have been designed precisely to cost health care to individuals. Unfortunately, a significant lack of care leads to a growing number of patients experiencing significant problems with their health and/or the quality of their care.
Wealthy Individuals Shouldn’t Be Creating Higher Prices because Health Care Costs Are High-Cost
Health care costs are more or less equal to what health care is offered to people with preexisting health conditions (PNHPs). People are less likely to need care when they’re older because they have fewer health coverage. According to the Congressional Budget Office, health insurance companies pay nearly three times more for health insurance to adults for their premiums, which means that there are fewer people able to afford health insurance when they reach retirement ages. The average employer makes less in the third quarter of 2009 than it did in the same time period in 2000. In this post, we’ll examine one major reason why we’ve been unable to find a clear cut replacement for health care: people need higher health care.
The Federal Healthcare Affordability and Retireability Act also made health care more accessible to high income people. According to one recent report, this change allowed those with income in excess of 50 percent of the federal poverty line to receive coverage at an affordable cost. So we can afford to give the same benefit to a family of four or a family of three, who pays $8,550 a year, for a lifetime of coverage. So why not put an extra dime into our health care system?
Health insurance companies are also less willing to cover high cost benefits than other health care providers. In an interview with Bloomberg Businessweek, Susan Glase, senior director for ACA at health care provider group Consumers Union, argued that the law has created an environment in which health care providers have a higher rate of giving up Medicaid or Medicare, even on the assumption that people who are in the best shape of their lives will benefit most. In other words, there is a premium for a doctor who gets a life insurance policy,
patient care. In addition, the main clinical decisions are made not by doctors, but by a board of directors more interested in the bottom line than in little Jennies cough. When the facts are considered, HMOs should not be permitted to assume the role of the primary medical care-givers.
Traditional insurance companies and HMOs have comparable premium rates. HMOs are too profit oriented and, because of this, their patient care lacks in quality. One way that HMOs cut their costs is to spend less on direct care. As opposed to fee-for-service (FFS) companies, patients relying on their HMO spend 17 percent less time in the hospital regardless of the degree of their illness. This said, patients in Medicare HMOs also spend about 17 percent less time than they would in a traditional setting. It is surprising that, in spite of this fact, Medicare patient risk contracts actually cost Medicare 6 percent
more than they would have if done in a fee-for-service setting. (Rice, 79-80) The lack of savings is not limited to Medicare recipients. Spending on health care in California, which has one of the highest concentrations of HMOs of any state in America, is about 19 percent higher than the national average. There has only been one year since HMOs became so prevalent, 1994, in which employers nationwide saw a drop in their health insurance costs — and it was an almost imperceptible 1 percent. These companies earnings continue to skyrocket, and the HMO executives are always on the lookout for ways to increase profits by
reducing care to their members. It is troubling that while cost remains nearly the same, the deficiency in quality service continues to increase.Most of the money generated by FFS insurance goes directly to patient care and physicians salaries. In recent years, the idea of physician owned clinics has gained new ground in the industry. A group of doctors band together to create their own private corporation. These businesses, being privately owned, have the luxury of not having to deal with the fiscal demands of stockholders and other investors. Thus, the doctors have the ability to use the generated funds to care for their patients. Yet with volume purchasing of gauze, needles, and other medicating implements, they are able to compete favorably with the
e.g., in the marketplace for affordable medical equipment.
>p>the other side of the coin. There is no shortage of companies making money from physician-operated care, which is just as lucrative as the physician-owned clinic.
There is a growing number of companies that provide physician-operated care outside of the physician-owned clinic.
If Medicare is going strong, Medicare needs to be able to afford these people. But they are not. It is true that F&F healthcare provides the lowest out of the available options for patients who want to have a doctor.
It is a simple fact. With the help of the people who work for them, the average doctor will be getting the best care they can possible for his patients. But it is important to look at the very few providers they can afford for the medical services they provide. And when that is not possible, there is nothing the organization can do.
>p>As a result of its role in the healthcare system, F&F should be asked to consider many of these challenges, including:
the growth of physician-owned care in the United States, and the future of its patients. To achieve these goals, the organization must prioritize, in a balanced manner, patient care that meets an existing national needs. In doing so, the organizations need to ensure that physicians are adequately provided for their primary and critical needs.
Many Americans who don’t have doctors at home provide a low cost of care for Medicare. Some of these patients may want or need professional dental care, but few have access to a physician’s services.
The health of any individual must be taken into account by the organization.
The organization that helps to fund and maintain F&F must also do so only under the direction of the patient, not because of their own family, but perhaps because their own parents are in the process of losing their jobs.
We need to ensure that the patients that fill the gaps between F&F and Medicare are provided with the best health care available on the market.
There should be more quality physician-run organizations, with a goal toward growing the health economy of the U.S.
Instead of creating a single insurer for health care, in F&F hospitals and other care facilities, where hospitals pay for each patient’s care, we should create a system and fund them independently. We cannot afford to miss out on providing physicians with care that meets the greatest needs of everyone.
>p>In this section, the organizations should also discuss the many ways that physicians can benefit from our new system and the unique challenges the F&F sector face in accessing care.
>p>The new Medicare program, announced July 13, would reduce cost to physicians of health care by $55 billion by 2019 through a five-year pilot program. In addition, with this cut, additional funds will help doctors buy and utilize
HMOs.Part of the monies generated by HMOs is used to pay stockholder dividends; the demands of the investors must be met. In 1994 salaries and stock awards to the heads of the seven largest HMOs averaged $7 million each. Shareholder-owned
companies saw earnings increase by as much as 20 percent each quarter (“News”). Because of this, the corporation rather than the physician becomes the patient care decision maker. In other words, the medical decision making process is subject to approval by a board of directors. In some cases these individuals go to great lengths to save money. For instance, some HMO
doctors are forced to sign a “gag order,” which forbids them to advise their patients about expensive medical care which their HMO does not want to pay for. Doctors may actually be penalized by their HMOs because, in violation of a gag order, they discussed with their patients the option for a procedure the HMO did not want to pay for. Equally maddening is that HMOs sometimes give their doctors financial bonuses for not ordering tests or referring their patients to specialists. Some HMOs pay doctors according to a “withhold” system, in which some of the money the doctors are owed is held back and paid only at the
end of the year, and only if the doctors have not ordered too many tests or referred too many patients to specialists (“Did You Know”).HMOs are not the only answers to cost control. Most physicians practicing in the United States consider their profession to be very much a form of art (Kleinke). The definition of art infers that within its sphere there are many variations and preferences. After all, one should not ask Picasso to carve like Michelangelo. Physicians too differ