thanks, Jeffrey, for the useful analysis of HMOs and productivity!

>The difficulty in measuring and quantifying health outcomes has been an
>important factor leading to practice protocols' primary focus on cost
>minimization. 

I think that even if they could measure output, they wouldn't care about
it. What they care about is total revenue minus total cost (or stated as a
rate of return). Because HMO revenues are largely fixed per patient once
the deal has been struck, they try to profit by cutting costs.

BTW, in case anyone cares, I agree with Anders' comment on "Doug's
question" and Harry's comment on "dialectics, etc."

in pen-l solidarity,
        
Jim Devine   [EMAIL PROTECTED] &
http://clawww.lmu.edu/1997F/ECON/jdevine.html
"The only cause of depression is prosperity." -- Clement Juglar. 




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