On Fri, 7 Nov 2003, Harry Pollard <[EMAIL PROTECTED]> wrote:[snip]
Why do you see the private sector is terrible at healthcare? I've already described the Kaiser-Permanente system, which I would say was the equal of any other in the world - private or government.
First, a personal story: Yesterday at work the head of HR sent around an email saying that as of January 1 the company is changing to a new healthcare provider (Old: Aetna and Oxford; new: Blue Cross/Blue Shild). It was about 1 PM, and I was thinking I might get thru the day without taking an Anti-anxiety pill, but that email raised my anxiety level way up because I worried that my current doctors might not acept the new insurance. I called the medical group I use, and they said they accept BC/BS "PPO" and "Identity" plans. I emailed the head of HR and asked if our new insurance was one of these. At first the head of HR replied that I would find out at the enrollment meeting on Nov 20, which did not help calm me down, but a while later I received another email saying that the plan was one the medical group I go to accepts. My anxiety level started going back down. I thanked the head of HR *profusely* for having checked this out for me.
Now, some thoughts:
The private sector. Technically, or, as I would prefer to
say, "formally", Kaiser-Permanente, Oxford, BC/BS et al.
are private sector. But, from the point of view of me
as a patient or my doctor as a member of a "medical group"
which itself may have well over 100 employees, these
entities are powerful bureaucracies with which we as
individuals interact much the same way as we would
interact with a government agency. Functionally
("materially"), I think that it is misleading to
call these non-governmental bureaucratic institutions
"private sector". My idea of private sector would be
the old doctor in individual private practice. I do
remember when my dentist worked alone.I think there are at least 3 "sectors": (1) Institutional-A (AKA "government"), (2) Institutional-B (non-"government" corporate institutions which have powerful influence over the shape of individuals' lives), and (3) Private.
Persons should not have to live in fear that they
will no longer be able to see the doctor they
have been seeing for 20 years ("You can always pay
out of pocket, fella." "Not really, because the
fee structure is based on insurance reimbursement
rates, not what average working persons could pay
out of pocket....").I have previously said I think that if our social
system really started encouraging healthful
life style, and if medical research was
oriented more toward high-leverage problems,
we could minimize the problem of having to
ration health care.
("low leverage" are things like
50 person team 50 hour operations to try to separate
one pair of conjoined twins, etc.).Government or "private", we live in a world that requires high levels of social coordination, don't we? Of course that too is something social policies could try to reduce over time.
And a stitch in time does often save nine.
(Was this worth writing? I hope I did not waste your time.)
\brad mccormick
--
Let your light so shine before men,
that they may see your good works.... (Matt 5:16)Prove all things; hold fast that which is good. (1 Thes 5:21)
<![%THINK;[SGML+APL]]> Brad McCormick, Ed.D. / [EMAIL PROTECTED] ----------------------------------------------------------------- Visit my website ==> http://www.users.cloud9.net/~bradmcc/
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