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Re: Bob, HMO's and God From: Robert J. Woolley (wooll005@tc.umn.edu) Mon May 10 21:03:21 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Zach Newton: "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" Previous message: john r miklos : "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" Next in thread: john r miklos : "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" Reply: john r miklos : "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" In message <37362B17.847E1D87@cheshire.net> writes: > Well, Bob, in the purest sense, yes the HMO would deny all care, however > they > can't quite get away with it. The industry jargon for what is spent on > patient care is indeed "loss" - not patient benefit. The "for profit" HMO's > goal is to keep the "loss" at under 75% of the premiums taken in, while the > "not-for-profit" HMO's aim to keep the "loss" at a maximum of 85% > > If they are TRULY interested in providing the care for the best $ value, > explain the following HMO decisions I have worked with for my patients: [cases snipped] I don't see how these cases effectively challenge the assertion that HMOs have an incentive to provide appropriate care. It is also true that corporations generally have an incentive to cut overhead costs, but are often notoriously wasteful of paper, people's time (with endless non-productive meetings), etc. That people do not always make decision inline with their incentives and goals is hardly evidecne that those incentives do not exist. --------------------------------------------------------------------------- --------------------------------------------------------------------------- Bob Woolley -- --------------------------------------------------------------------------- St. Paul, Minnesota "If on visiting the dwelling of a man of slender means we find that he contents himself with cheap carpets and very plain furniture in order that he may purchase books, he rises at once in our esteem." --Henry Ward Beecher Next message: Zach Newton: "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" Previous message: john r miklos : "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" Next in thread: john r miklos : "Re: Tension Free Vaginal Tape for Bladder/urethral suspension" Reply: john r miklos : "Re: Tension Free Vaginal Tape for Bladder/urethral suspension"

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