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RE: [IP] HMOs and Endos

Bonnie Richardson [mailto:email @ redacted] wrote:

> 	Absolutely true!   An HMO exists only to make a profit.  While
> Doctors also want to make a profit (those med school loans 
> are tough) they,
> hopefully, believe in the Hippocratic Oath and have a more 
> altruistic soul
> and will act in your best interests.  The HMO business never 
> acts in your
> best interest, only in their own.  I am so grateful that I am 
> not in an HMO.
> I hope they soon become extinct!

*ANY* operation that wants to stay in business very long needs to make a
profit.  This holds for all private practices, hospitals, pharmacies, etc.,
etc., etc.  To think otherwise is na´ve.

Most HMOs are non-profit organizations.  That probably deserves some
clarification, however.  Non-profit doesn't mean they're not interested in
profitability . . . it means that they cannot sell stock in the company.
Non-profit organizations operate on debt, not equity.  But the better the
bottom line, the more debt they can service, and the more they can grow.
For profit means they can sell stock, offer dividends, etc.  But any
organization that isn't interested in a positive bottom line doesn't
survive.  Period.

OTOH, there's more to the organization of all health operations.  In the
United States, by law, any organization offering health care must be owned
by a physician or other health professional such as a chiropractor,
podiatrist, etc., but the administration may be operated by anyone.  For
example, Kaiser Permanente is really two entities: the Kaiser Foundation,
which operates the facilities, hires the nurses, etc., and the Permanente
Medical Group which runs the clinical aspects of the operation and to who
hires physicians and supervises the physicians, nurses, PAs, etc.  Kaiser
Permanente, the largest HMO, actually does a very good job at balancing
health care needs of its patients and seeing to the financial health of the
organization.  Most HMOs are not as adept, and, in some cases, the
administration has the stronger position.

The fact is that healthcare costs in the United States have gotten so far
out of hand that *something* is going to have to be done -- that is some
form of managed care.  That's what HMOs do -- managed care.  If it's done
well, it can be a win-win proposition.  That doesn't mean that it will be
perfect.  If it's done poorly, it's a disaster.  One has to approach one's
health care more assertively with managed care than with the "old" system.

But too many physicians and other healthcare providers are spending so much
energy protesting the possibility instead of accepting its inevitability
that the system is going to be reformed without their input if they're not
careful -- and the system will be poorer for it.  But the AMA and other
organizations can be more positive and simply accept that something MUST be
done and get with the program to help devise an *optimal* program that
satisfies the needs of the most numbers of people while controlling the
costs so that the whole system doesn't go bankrupt and we all end up with
poorer healthcare.

The solutions is NOT to condemn HMOs or other managed care systems, but to
control some of the other issues.  Out society has become litigious in the
extreme, and the smallest instance of a poor outcome is likely to result in
a medical malpractice case.  And, unfortunately, since most juries are
sympathetic to the plaintiffs against "rich" doctors, they will, more often
than not, find for the plaintiff.  Insurance companies have generally found
that it is more cost effective to settle, regardless of the merits of the
suit, rather than fight the allegations in court.  As a result, you and I
have to pay more and more for our healthcare *TO COVER THE COST OF

One solution to this situation might be to provide an automatic counter suit
system whereby anyone who *loses* a malpractice suit must pay the court and
legal fees as well as a penalty to the defendant.  That might prompt a more
balanced approach to the filing of malpractice suits and put an end to
unmerited allegations made in court.

Here endeth *my* rant.

Jim Handsfield
mailto:email @ redacted OR
mailto:email @ redacted

The opinions expressed are my own and do not necessarily represent those of
my wife who runs this house and makes more important decisions than I do.
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