Health Care Reform 3
“Managed Care is a system to integrate the delivery and financing of comprehensive health care services to covered individuals by means of arrangement with selected health care providers; explicit criteria for the selection of health-care providers; significant financial incentives for members to use providers and procedures associated with the plan; and formal programs for quality assurance and utilization review. Providers of managed care include health maintenance organizations (HMOs) and preferred provider organizations (PPOs), as well as traditional insurance companies” (Chippewa County-Montevideo Hospital and Medical Clinic ). So understanding that a Managed Care system is not run by the government, it is competitive with other organizations for customers, and provides options of financing and the access to health care. The goal of managed care systems is to reduce the costs of providing health benefits and improve the quality of care. The down fall of Managed Care systems is that the criteria chosen by certain people will not always sit well with the consumers. A way to improve the HMO’s is to analyze the legitimacy of the goals of the Managed Care systems, and give more control to the public to form policies with accessing quality health care.
Who needs to act to reform the goals of the HMO’s? I feel that it needs to be a joint effort between the HMO’s and the consumers. As human beings we like to be in complete control, which sometimes can hinder us because we are not all health care specialist and do not understand the complexities of health care. Everyone strives for a better solution and the authority that HMO’s have of deciding our fate can be threatening to people’s ideas. The public, patients, and clinicians have to entrust that the moral authority that the Managed Care systems possess are going to benefit them. The HMO’s have a great task of distributing health care. Our group really supports the idea of universal health care. According to Deloitte Development increasing taxes to help provide health insurance coverage for the 47 million is opposed by 43%, 32% is mixed, and only 25% is in favor of increasing taxes (LLP, 2009). So this is a bit disheartening because most people are not willing to part with their money, even if it will be saving us money in the long run. According to USA TODAY the National spending grew a projected 7.8% in 2003, down from 9.3% in 2002. The country spent on the average of $5,805 per person in 2003. This amount is much higher than the per capita amount spent in other industrialized nations. (Appleby, 2004 )The consumers job is to very boldly announce their expectations of the HMO’s and if their needs are not being met to voice their opinions and demand change.
What ways can we improve the communication between HMO’s and the people buying their coverage? Laws could be passed by Congress that force the HMO’s to take more public surveys to get input from the public so their plans of coverage are the most cost efficient and the highest quality. On the other side of that coin is educating the public of heath care coverage. It is so easy to throw in your disappointments with a program and how it’s not helping you but if all you are doing is complaining then really what right do you have? You are not bettering yourself or others if you just get on your soap box and complain. Action is key, lobbying for changes and advocating are positive ways to get the same disappointments across but in a productive way.
By taking these steps to better both sides hopefully the access, quality, cost, and overall communication will improve. Being optimistic is a huge advantage because it’s not being oblivious to problems, but by having a different attitude much more is accomplished. “The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care” (John R. Battista, 1999). Even though this talk occurred in 1999, the argument still stands strong we are paying too much money and there are too many people uninsured in the United States. When are we going to get off our high horse and look at other nations who are thriving because of Universal Health Care? It is about time we step up our game and help the 46 million people who are uninsured. (WOODRUFF, 2009) By picking apart HMOs’ we can reduce the cost, increase access, and also quality because we will know what the consumers need.
Works Cited
Appleby, J. (2004 , Febuary 12). Almost $1.7 trillion spent on health care in '03. Retrieved March 30, 2009, from USA TODAY: http://www.usatoday.com/money/industries/health/2004-02-12-healthcosts_x.htm
“Managed Care is a system to integrate the delivery and financing of comprehensive health care services to covered individuals by means of arrangement with selected health care providers; explicit criteria for the selection of health-care providers; significant financial incentives for members to use providers and procedures associated with the plan; and formal programs for quality assurance and utilization review. Providers of managed care include health maintenance organizations (HMOs) and preferred provider organizations (PPOs), as well as traditional insurance companies” (Chippewa County-Montevideo Hospital and Medical Clinic ). So understanding that a Managed Care system is not run by the government, it is competitive with other organizations for customers, and provides options of financing and the access to health care. The goal of managed care systems is to reduce the costs of providing health benefits and improve the quality of care. The down fall of Managed Care systems is that the criteria chosen by certain people will not always sit well with the consumers. A way to improve the HMO’s is to analyze the legitimacy of the goals of the Managed Care systems, and give more control to the public to form policies with accessing quality health care.
Who needs to act to reform the goals of the HMO’s? I feel that it needs to be a joint effort between the HMO’s and the consumers. As human beings we like to be in complete control, which sometimes can hinder us because we are not all health care specialist and do not understand the complexities of health care. Everyone strives for a better solution and the authority that HMO’s have of deciding our fate can be threatening to people’s ideas. The public, patients, and clinicians have to entrust that the moral authority that the Managed Care systems possess are going to benefit them. The HMO’s have a great task of distributing health care. Our group really supports the idea of universal health care. According to Deloitte Development increasing taxes to help provide health insurance coverage for the 47 million is opposed by 43%, 32% is mixed, and only 25% is in favor of increasing taxes (LLP, 2009). So this is a bit disheartening because most people are not willing to part with their money, even if it will be saving us money in the long run. According to USA TODAY the National spending grew a projected 7.8% in 2003, down from 9.3% in 2002. The country spent on the average of $5,805 per person in 2003. This amount is much higher than the per capita amount spent in other industrialized nations. (Appleby, 2004 )The consumers job is to very boldly announce their expectations of the HMO’s and if their needs are not being met to voice their opinions and demand change.
What ways can we improve the communication between HMO’s and the people buying their coverage? Laws could be passed by Congress that force the HMO’s to take more public surveys to get input from the public so their plans of coverage are the most cost efficient and the highest quality. On the other side of that coin is educating the public of heath care coverage. It is so easy to throw in your disappointments with a program and how it’s not helping you but if all you are doing is complaining then really what right do you have? You are not bettering yourself or others if you just get on your soap box and complain. Action is key, lobbying for changes and advocating are positive ways to get the same disappointments across but in a productive way.
By taking these steps to better both sides hopefully the access, quality, cost, and overall communication will improve. Being optimistic is a huge advantage because it’s not being oblivious to problems, but by having a different attitude much more is accomplished. “The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care” (John R. Battista, 1999). Even though this talk occurred in 1999, the argument still stands strong we are paying too much money and there are too many people uninsured in the United States. When are we going to get off our high horse and look at other nations who are thriving because of Universal Health Care? It is about time we step up our game and help the 46 million people who are uninsured. (WOODRUFF, 2009) By picking apart HMOs’ we can reduce the cost, increase access, and also quality because we will know what the consumers need.
Works Cited
Appleby, J. (2004 , Febuary 12). Almost $1.7 trillion spent on health care in '03. Retrieved March 30, 2009, from USA TODAY: http://www.usatoday.com/money/industries/health/2004-02-12-healthcosts_x.htm
Chippewa County-Montevideo Hospital and Medical Clinic . (n.d.). Retrieved March 27, 2009, from Health Care Terms: http://www.montevideomedical.com/Pages/Page_05.htm
Daniels, N. (1998). The Ethics Of Accountability In Managed Care Reform. Retrieved March 27, 2009, from Health Affairs: content.healthaffairs.org/cgi/reprint/17/5/50.pdf
John R. Battista, M. a. (1999, June 4th). The Case For Single Payer, Universal Health Care For The United States. Retrieved March 30, 2009, from Connecticut Coalition for Universal Health Care : http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm
LLP, D. (2009, March 16). Health Care and Public Policy: What Do Americans Really Want? Retrieved March 27, 2009, from Deloitte.: http://www.deloitte.com/dtt/article/0,1002,sid%253D80772%2526cid%253D242408,00.html
WOODRUFF, J. (2009, Febuary 11). The Uninsured in America. Retrieved March 30, 2009, from The Online News Hour: http://www.pbs.org/newshour/indepth_coverage/health/uninsured/
"Laws could be passed by Congress that force the HMO’s to take more public surveys to get input from the public so their plans of coverage are the most cost efficient and the highest quality"
ReplyDeleteThis would be a great idea, costumer satisfaction surveys are a great way of getting people's input and even some ideas of ways to improve or reform your company. It makes people feel like they aren't just a number and actually have an input on their care. This would make people feel better about the company and even help you know what your company needs to improve upon.
I agree that a Universal health system would be a great way to help get the 46 million insured. However I think with our country it is going to take a long time for that to happen.
ReplyDeleteFirst of all our country is way to sick. A country like China doesn't have to worry about sickness like we do. They deal with it in other ways. Our country can't do that.
Our country also costs to much. We have to pay for a lot of things that China doesn't have to. When hundreds of dollars are being taken out of our pay checks no wonder why no one wants to put in the extra money to help others, we are just trying to survive ourselves.
So, yes, I do think universal health care can be good for us, but I seriously don't think it will happen in the next ten years. I think attitudes are a big thing though, we still have to be optimistic and maybe things will change faster then we think.
It's hard to ask middle class people to put more of their paychecks into taxes for coverage for the uninsured. We already pay a substantial amount for our own insurance. And I don't even ever go to the doctor because the co-pays and deductibles are really high.
ReplyDeleteI thought your health care reform was very interesting. I really liked your second paragraph. I agree that everyone what to be in control. From my own observation I find it interesting the people what to be in control even when they have no idea what it is that they are in control of and what they are suppose to do. They would rather be in control and mess everything up than give up their control/rights.
ReplyDeleteI also find it very believable that so many people are unwilling to part with their money even if it will be better in the long run. People have a hard time understanding this concept. Most of us can only see the now, or the very near future. If more Americans were living to better the long run they would be eating healthier, exercising more, voting, but instead they look at what will benefit them now. However, I think if the right approach were taken many American would be willing to change because right now the health care system isn't working and something needs to be done.
There are going to be set backs before we move forward. The reality is we have to start doing something. I really do not feel that with a private system only we can solve the health care crisis. There is a bottom line in health care when profits are made, and that is really sick people in order to use the products available. We have to move more towards a government funded health care system, which means people of this country funded health care system. When we all pay for it, we will make sure people are healthy.
ReplyDeleteAll this HMO talk is confusing. I like that you are addressing the real need which is universal access to health care. What we have now is actually sick care. As an individual I have to watch out for my own health, which isn't a bad thing. Until we have incentives for being healthy, instead of payoffs for being sick, I opt-out of this system.
ReplyDelete