Sunday, November 10, 2013
ACA Obomacare
The anti Obamacare imagination is running on super charged paranoia - the plan is to control costs - going from A to C to get to B (or costs will or is bankrupting the government and putting us in a very uncompetative position - one big reason jobs are leaving the country is the cost of health care in the wage package) the method to control costs is payment on a per capita basis for managed care (HMO) the means is by national chains of Affordable Health Coverage | Quality Care | Kaiser Permanente ® www.kaiserpermanente.org/
Kaiser Permanente offers comprehensive, affordable health coverage plans for individual & family, medicare, employers, and large group. Join us and thrive!
Such providers cost 30% to 50% less than fee for service (the more you do the more your are paid) because they have prepaid per capita plans where the more you do the less you earn from a fixed amount of money to care for the clients .
This was promoted by the Nixon administration in 1973
Humana, HCA, etc owners, franchisees, of integrated health care in network and insurance for out of network.
Managed care - Wikipedia, the free encyclopedia
en.wikipedia.org/wiki/Managed_care
From Private Fee-For-Service (PFFS) which is the core of the problem - There are basically two types of Health Insurance: Fee-for-Service (Indemnity) and Managed Care. Health ......intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.[1]
The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973.
Paul Starr suggests in his analysis of the American health care system (i.e., The Social Transformation of American Medicine) that Richard Nixon, advised by the "father of Health Maintenance Organizations", Dr. Paul M. Ellwood, Jr., was the first mainstream political leader to take deliberate steps to change American health care from its longstanding not-for-profit business principles into a for-profit model that would be driven by the insurance industry. In 1973, Congress passed the Health Maintenance Organization Act, which encouraged rapid growth of Health Maintenance Organizations (HMOs), the first form of managed care.
By LAURA MECKLER
CONNECT
Insurance A collection of health care groups calling itself the Health Reform Dialogue issued a set of recommendations today aimed at governing the debate over restructuring health care, and their ideas are generally consistent with the direction Democrats are heading. (Read the report here.)
That could give a boost to the health revamp effort under way on Capitol Hill. But the group sidestepped the thorniest issues, such as whether individuals or employers should be required to buy or offer coverage, and whether a government-run health plan should be available to compete with private companies.
On other matters, the group, which includes representatives of various medical and business associations, found consensus. It said it favored a “fair and transparent” marketplace for buying insurance, with sliding-scale subsidies based on income, and it wanted “reforms necessary” so that everyone will buy or otherwise obtain insurance. It also endorsed more federal funding for Medicaid, the health program for the poor run by the states.
The Health Reform Dialogue included a long list of “wellness and prevention” ideas, most of which have wide support, such as better coverage for prevention services, investments in health information technology, eliminating disparities in health and helping people improve their own health.
“What is unprecedented about this is never before a health reform debate began did you have such a wide spectrum of organizations finding such common ground,” said Ron Pollack, president of the consumer group Families USA, who participated in the dialogue. “That creates a very positive context of health reform moving forward.”
Organizations that participated in the Health Reform Dialogue include: AARP, Advanced Medical Technology Association, America’s Health Insurance Plans, American Cancer Society Cancer Action Network, American College of Physicians, American Hospital Association, American Medical Association, American Nurses Association, American Public Health Association, Blue Cross and Blue Shield Association, Business Roundtable, Catholic Health Association of the United States, Families USA, Federation of American Hospitals, Healthcare Leadership Council, National Federation of Independent Business, Pharmaceutical Research and Manufacturers of America, and the U.S. Chamber of Commerce.
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10:02 am September 2, 2009
Dr Peter Pflaum wrote :
http://www.wiredbrain.com POLICY AND POLITICS:
To get a change in the American society takes good policy, tested at the state and local level, and good politics. What is the “hook” or appeal in selling health care reform? The system is out of control and requires fixing (as has been true over the last 50 years) but effectiveness and efficiency are hot political buttons. What does it take to crystallize public opinion? Amazon’s Edward L. Bernays Page
The progressive’s reforms at the turn of the century were based on SHAME and GUILT. The shame of the cities and meat packing was direct threats to citizen’s welfare and safety. The PR message now should be “are we the only modern society without universal health care?” Canadians are taken care of, French are taken care of, and people are better treated in dozens of countries at less cost! Stop being so afraid of the truth and the lie that we have the best in the world – we are in grave danger, there is a crisis, panic .. Health Insurance Costs: http://www.hlc.org/HRD_Common_Ground_–_FINAL.pdf
WRONG: NOT TRUE – FACT CHECK…AND IMPORTANT
The face of clear and present danger should be personal stories of middle class families destroyed by getting sick. The cornier the better, more soap opera the better, the more painful the better. We are talking about deep sub conscience motivation below the rational mind; as is most effective advertising. Bernays was an outspoken proponent of propaganda as a tool for democratic and corporate manipulation of the population. His 1928 bombshell Propaganda lays out his eerily prescient vision for using propaganda to regiment the collective mind in a variety of areas, including government, politics, art, science and education. To read this book today is to frightfully comprehend what our contemporary institutions of government and business have become in regards to organized manipulation of the masses.
The American public is not conservative about money. They are not financially conservative, but motivated by immediate satisfaction. The traditional middle class put off purchases until there was money in the bank, (puritan ethic) while lower class people demanded immediate gratification. If they want something they pay for it on the “old never never” credit cards and then put it on their equity loans using their homestead as an ATM machine. Thus was the cause of the economic crisis.
They vote for politicians who promise benefits without pain or taxes, the “check is in the mail campaign”. The “conservative movement” is more social than economic and based on prejudices between regional, racial, tribal, moral family values, religious, WASP vs. foreigners not self interest since people are voting against their own economic self-interests. Republican get tax cuts for the rich 1% by their “values” agenda based on prejudice and fundamentalism. The rich fear a liberal popularism of buying vote with an endless stream of entitlements the rich end up paying for.
In Health Insurance Market the fault does not primarily lie with the insurance industry but a twist in employer based policies. Two thirds of the premium cost paid by the employer is invisible to the employee. If the employee pays $300 a month the company pays $600 for a total of $900 or $10,800 a year. If there is a prepaid plan that is more effective and efficient and cost less but is not as convenient the small reduction in employee cost is not motivation. The employer needs to reward the employee with a share of the employer’s savings. The employee pays $200 a month and saves $100 but the employer saves $200 that needs to be paid in wages so the full $300 or $3600 saving is manifest. The saving should not be taxed but be pretax as are health benefits.
BREAVEHEART:
A new AMERICARE in the Centers for Medicare and Medicaid Services (CMS), determines to be federally qualified or that are an approved Competitive Medical Plan (CMP) http://www.opm.gov/insure/health/planinfo/types.asp
What is needed are new comprehensive, Medicare medical plans on a regional and state wide basis. In short it opens the Medicare system to everyone in the exchange. At the same time it moves Medicare and Medicaid to Medicare or service alliances based on per capital costs or bundled, global payments that could decrease “fee for service” and cut costs by another 20%. This is a form of single buyer that has proved itself the best may to reduce costs and improve quality. The Clinton plan was universal as in all other industrial countries. BUT….
One person’s waste, abuse or fraud is another person’s income, their private plane, and Palm Beach mansion. The policy that could solve the problem is not political possible, what is politically possible does not solve the problem.
The reason “the public option” is critical is that employers can migrate from over priced private plans to a form of Medicare for all. When almost everyone is included there is less cost shifting (where uncollected bill of uninsured are paid by the insured) and premium could decline. The insurance companies don’t want public competition; and the medical community is not excited by the change that reduces their incomes. NOW THE PLOT THICKENS:
Kaiser Permanente offers comprehensive, affordable health coverage plans for individual & family, medicare, employers, and large group. Join us and thrive!
Such providers cost 30% to 50% less than fee for service (the more you do the more your are paid) because they have prepaid per capita plans where the more you do the less you earn from a fixed amount of money to care for the clients .
This was promoted by the Nixon administration in 1973
Humana, HCA, etc owners, franchisees, of integrated health care in network and insurance for out of network.
Managed care - Wikipedia, the free encyclopedia
en.wikipedia.org/wiki/Managed_care
From Private Fee-For-Service (PFFS) which is the core of the problem - There are basically two types of Health Insurance: Fee-for-Service (Indemnity) and Managed Care. Health ......intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.[1]
The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of 1973.
Paul Starr suggests in his analysis of the American health care system (i.e., The Social Transformation of American Medicine) that Richard Nixon, advised by the "father of Health Maintenance Organizations", Dr. Paul M. Ellwood, Jr., was the first mainstream political leader to take deliberate steps to change American health care from its longstanding not-for-profit business principles into a for-profit model that would be driven by the insurance industry. In 1973, Congress passed the Health Maintenance Organization Act, which encouraged rapid growth of Health Maintenance Organizations (HMOs), the first form of managed care.
By LAURA MECKLER
CONNECT
Insurance A collection of health care groups calling itself the Health Reform Dialogue issued a set of recommendations today aimed at governing the debate over restructuring health care, and their ideas are generally consistent with the direction Democrats are heading. (Read the report here.)
That could give a boost to the health revamp effort under way on Capitol Hill. But the group sidestepped the thorniest issues, such as whether individuals or employers should be required to buy or offer coverage, and whether a government-run health plan should be available to compete with private companies.
On other matters, the group, which includes representatives of various medical and business associations, found consensus. It said it favored a “fair and transparent” marketplace for buying insurance, with sliding-scale subsidies based on income, and it wanted “reforms necessary” so that everyone will buy or otherwise obtain insurance. It also endorsed more federal funding for Medicaid, the health program for the poor run by the states.
The Health Reform Dialogue included a long list of “wellness and prevention” ideas, most of which have wide support, such as better coverage for prevention services, investments in health information technology, eliminating disparities in health and helping people improve their own health.
“What is unprecedented about this is never before a health reform debate began did you have such a wide spectrum of organizations finding such common ground,” said Ron Pollack, president of the consumer group Families USA, who participated in the dialogue. “That creates a very positive context of health reform moving forward.”
Organizations that participated in the Health Reform Dialogue include: AARP, Advanced Medical Technology Association, America’s Health Insurance Plans, American Cancer Society Cancer Action Network, American College of Physicians, American Hospital Association, American Medical Association, American Nurses Association, American Public Health Association, Blue Cross and Blue Shield Association, Business Roundtable, Catholic Health Association of the United States, Families USA, Federation of American Hospitals, Healthcare Leadership Council, National Federation of Independent Business, Pharmaceutical Research and Manufacturers of America, and the U.S. Chamber of Commerce.
Add a Comment
Name
We welcome thoughtful comments from readers. Please comply with our guidelines. Our blogs do not require the use of your real name.
Comment
10:02 am September 2, 2009
Dr Peter Pflaum wrote :
http://www.wiredbrain.com POLICY AND POLITICS:
To get a change in the American society takes good policy, tested at the state and local level, and good politics. What is the “hook” or appeal in selling health care reform? The system is out of control and requires fixing (as has been true over the last 50 years) but effectiveness and efficiency are hot political buttons. What does it take to crystallize public opinion? Amazon’s Edward L. Bernays Page
The progressive’s reforms at the turn of the century were based on SHAME and GUILT. The shame of the cities and meat packing was direct threats to citizen’s welfare and safety. The PR message now should be “are we the only modern society without universal health care?” Canadians are taken care of, French are taken care of, and people are better treated in dozens of countries at less cost! Stop being so afraid of the truth and the lie that we have the best in the world – we are in grave danger, there is a crisis, panic .. Health Insurance Costs: http://www.hlc.org/HRD_Common_Ground_–_FINAL.pdf
WRONG: NOT TRUE – FACT CHECK…AND IMPORTANT
The face of clear and present danger should be personal stories of middle class families destroyed by getting sick. The cornier the better, more soap opera the better, the more painful the better. We are talking about deep sub conscience motivation below the rational mind; as is most effective advertising. Bernays was an outspoken proponent of propaganda as a tool for democratic and corporate manipulation of the population. His 1928 bombshell Propaganda lays out his eerily prescient vision for using propaganda to regiment the collective mind in a variety of areas, including government, politics, art, science and education. To read this book today is to frightfully comprehend what our contemporary institutions of government and business have become in regards to organized manipulation of the masses.
The American public is not conservative about money. They are not financially conservative, but motivated by immediate satisfaction. The traditional middle class put off purchases until there was money in the bank, (puritan ethic) while lower class people demanded immediate gratification. If they want something they pay for it on the “old never never” credit cards and then put it on their equity loans using their homestead as an ATM machine. Thus was the cause of the economic crisis.
They vote for politicians who promise benefits without pain or taxes, the “check is in the mail campaign”. The “conservative movement” is more social than economic and based on prejudices between regional, racial, tribal, moral family values, religious, WASP vs. foreigners not self interest since people are voting against their own economic self-interests. Republican get tax cuts for the rich 1% by their “values” agenda based on prejudice and fundamentalism. The rich fear a liberal popularism of buying vote with an endless stream of entitlements the rich end up paying for.
In Health Insurance Market the fault does not primarily lie with the insurance industry but a twist in employer based policies. Two thirds of the premium cost paid by the employer is invisible to the employee. If the employee pays $300 a month the company pays $600 for a total of $900 or $10,800 a year. If there is a prepaid plan that is more effective and efficient and cost less but is not as convenient the small reduction in employee cost is not motivation. The employer needs to reward the employee with a share of the employer’s savings. The employee pays $200 a month and saves $100 but the employer saves $200 that needs to be paid in wages so the full $300 or $3600 saving is manifest. The saving should not be taxed but be pretax as are health benefits.
BREAVEHEART:
A new AMERICARE in the Centers for Medicare and Medicaid Services (CMS), determines to be federally qualified or that are an approved Competitive Medical Plan (CMP) http://www.opm.gov/insure/health/planinfo/types.asp
What is needed are new comprehensive, Medicare medical plans on a regional and state wide basis. In short it opens the Medicare system to everyone in the exchange. At the same time it moves Medicare and Medicaid to Medicare or service alliances based on per capital costs or bundled, global payments that could decrease “fee for service” and cut costs by another 20%. This is a form of single buyer that has proved itself the best may to reduce costs and improve quality. The Clinton plan was universal as in all other industrial countries. BUT….
One person’s waste, abuse or fraud is another person’s income, their private plane, and Palm Beach mansion. The policy that could solve the problem is not political possible, what is politically possible does not solve the problem.
The reason “the public option” is critical is that employers can migrate from over priced private plans to a form of Medicare for all. When almost everyone is included there is less cost shifting (where uncollected bill of uninsured are paid by the insured) and premium could decline. The insurance companies don’t want public competition; and the medical community is not excited by the change that reduces their incomes. NOW THE PLOT THICKENS:
