What I think about American Health Insurance
Could someone PLEASE mention in the news and discussion that not all health insurance companies are for profit?
Kaiser Permanente is not, and Blue Cross/Blue Shield companies are not.
That doesn't mean they don't try to end up in the black. They need money to pay interest on their loans, and to maintain their I.T. and other overhead.
Because I work in healthcare I.T., very close to insurance, several people have asked me what I would like to happen with American Health insurance and 'Obama's Health Care Proposal'.
I remind them that is is not his; he left it to the U.S. Congress to draft and refine it.
I would like to see an end to insurance companies terminating a person's policy. In order to do that, there must be a greater pool of people who pay in and don't take out, to cover the expenses of those who do take out a lot because of expensive medical treatments. An important part of the proposals try to answer that question:
Do we replace all insurance premiums with taxes?
Do we demand the equivalent of premiums from those who have chosen not to purchase (or couldn't afford) insurance?
When HCHP started (like Kaiser, only in Boston), their casemix of subscribers was only employed people and their families.
They started to include people who were on Medicaid as a trade off to remove them from their homes in order to acquire land for their clinics and hospitals.
It was a whole different ballgame when the casemix included people who used more resources than Medicaid could cover.
There is a lot of pressure on physicians to conform to standard practice for diagnostics and treatment.
On the other hand there is research. Do we want research to stop?
On the other hand there are people who (quite reasonably) say "if they had done more testing, they might have found the cause and cure..."
There was an article in the SF Chronicle recently about medical errors, and how CPOE (Computerized Provider Order Entry) could reduce errors.
The software is there, but the setup is expensive and labor intensive. It would be like hand writing a medical dictionary, because sets of orders have to be designed and built and maintained.
It is a multi-million dollar commitment for a hospital system to make, and a major cultural shift.
There will always be human error. Every day I handle human error in the use of the Electronic Medical Record, including documenting medication administration. Usually the humans know that they have done the wrong thing, and they use human communication to make sure the other people managing the patient do not rely on the EMR for that information until the error has been cleaned up.
We want 100% perfect diagnoses and treatments and cures. I certainly would if it involved myself or my family or other loved ones.
Medical care mostly succeeds. I hate the sensationalism of journalism that does stupid things with statistics, such as listing the hospitals where largest number or % of people die.
If they were to factor in the risk level of that hospital's casemix, they would find that the comparisons are much more mundane. Trauma Centers and Teaching (read research) hospitals take in higher risk patients.
OK, I'm done for now.
Responses are welcome.
I will not take any comments personally.
Kaiser Permanente is not, and Blue Cross/Blue Shield companies are not.
That doesn't mean they don't try to end up in the black. They need money to pay interest on their loans, and to maintain their I.T. and other overhead.
Because I work in healthcare I.T., very close to insurance, several people have asked me what I would like to happen with American Health insurance and 'Obama's Health Care Proposal'.
I remind them that is is not his; he left it to the U.S. Congress to draft and refine it.
I would like to see an end to insurance companies terminating a person's policy. In order to do that, there must be a greater pool of people who pay in and don't take out, to cover the expenses of those who do take out a lot because of expensive medical treatments. An important part of the proposals try to answer that question:
Do we replace all insurance premiums with taxes?
Do we demand the equivalent of premiums from those who have chosen not to purchase (or couldn't afford) insurance?
When HCHP started (like Kaiser, only in Boston), their casemix of subscribers was only employed people and their families.
They started to include people who were on Medicaid as a trade off to remove them from their homes in order to acquire land for their clinics and hospitals.
It was a whole different ballgame when the casemix included people who used more resources than Medicaid could cover.
There is a lot of pressure on physicians to conform to standard practice for diagnostics and treatment.
On the other hand there is research. Do we want research to stop?
On the other hand there are people who (quite reasonably) say "if they had done more testing, they might have found the cause and cure..."
There was an article in the SF Chronicle recently about medical errors, and how CPOE (Computerized Provider Order Entry) could reduce errors.
The software is there, but the setup is expensive and labor intensive. It would be like hand writing a medical dictionary, because sets of orders have to be designed and built and maintained.
It is a multi-million dollar commitment for a hospital system to make, and a major cultural shift.
There will always be human error. Every day I handle human error in the use of the Electronic Medical Record, including documenting medication administration. Usually the humans know that they have done the wrong thing, and they use human communication to make sure the other people managing the patient do not rely on the EMR for that information until the error has been cleaned up.
We want 100% perfect diagnoses and treatments and cures. I certainly would if it involved myself or my family or other loved ones.
Medical care mostly succeeds. I hate the sensationalism of journalism that does stupid things with statistics, such as listing the hospitals where largest number or % of people die.
If they were to factor in the risk level of that hospital's casemix, they would find that the comparisons are much more mundane. Trauma Centers and Teaching (read research) hospitals take in higher risk patients.
OK, I'm done for now.
Responses are welcome.
I will not take any comments personally.