Re: [Paddlewise] briefing guide

From: Richard Culpeper <culpeper_at_tbaytel.net>
Date: Mon, 27 Dec 1999 12:36:44 -0500
Hey Nick:

You asked what are HMOs?  HMOs are health maintenance organizations.  They provide health care to voluntarily enrolled individuals and families in a particular geographic area by member physicians with limited referral to outside specialists, and are financed
by fixed periodic payments determined in advance.  Think of them as private hospitals/clinics/Dr.'s offices paid for by private insurance.

Costs are kept down by only treating people who are paid up, thus avoiding having to treat poor people.  HMOs work nicely for well-off people living in countries which have health systems which are generally inadequate to meeting their populations' needs.
Unfortunately, because they shift the burden of providing health services for poor people onto the state while reducing the tax base from the well-off, they contribute to the general collapse of national health systems.

One would think that this would occur only in impoverished nations, but oddly enough it seems to be more related to a national attitude toward both health care and poverty, rather than GDP.  Thus you end up with some very sad statistics, such as the infant
mortality rate in the US (where HMOs are extremely popular) being tied for the worst of any G-7 nation, despite people in the US spending far more per capita on health.  (Similarly, the average life span in the US is the lowest of any of the G-7 nations,
although the gun cult affects these numbers.)  The difference is that while the people of the US spend far more on health care, the spending is done through the private rather than public sector, where again the US ranks last.  While privatization works nicely
for the well-off, it leads to greater costs and fewer benefits for the general population, and this translates directly and most tragically into more dead babies.

In conclusion, HMOs are symptoms of inequitable health systems.  Despite how prosperous a nation may appear, the state of its economy does not necessarily correlate to how socially advanced it is.  For residents of such nations, it is wise to carry proof of
adequate medical insurance to avoid treatment discrimination based on income.  For people visiting such nations, it is important to carry proof of adequate medical insurance which explains that the non-resident's bill will be paid regardless of the residency
issue.

Cheers,
Richard Culpeper

Data from World Health Organization:  "World Health Report 1999:  Basic Indicators for all Member States" at http://www.who.int/whr/1999/en/indicators.htm

Ranked by infant mortality
US-- inf. mort. 7/1000--male life 73--female life 80--% of GDP spent on health 14.0--public sector % of total on health 47
Italy--inf. mort. 7/1000--male life 75--female life 81--% of GDP spent on health 07.6--public sector % of total on health 70
UK--inf. mort. 7/1000--male life 75--female life 80--% of GDP spent on health 06.9--public sector % of total on health 84
Can.--inf. mort. 6/1000--male life 76--female life 82--% of GDP spent on health 09.2--public sector % of total on health 71
Fr.--inf. mort. 6/1000--male life 74--female life 82--% of GDP spent on health 09.7--public sector % of total on health 81
Ger.--inf. mort. 5/1000--male life 74--female life 80--% of GDP spent on health 10.5--public sector % of total on health 78
Jap.--inf. mort. 4/1000--male life 77--female life 83--% of GDP spent on health 07.2--public sector % of total on health 78

Ranked by % of GDP spent on health
US--inf. mort. 7/1000--male life 73--female life 80--% of GDP spent on health 14.0--public sector % of total on health 47
Ger.--inf. mort. 5/1000--male life 74--female life 80--% of GDP spent on health 10.5--public sector % of total on health 78
Fr.--inf. mort. 6/1000--male life 74--female life 82--% of GDP spent on health 09.7--public sector % of total on health 81
Can.--inf. mort. 6/1000--male life 76--female life 82--% of GDP spent on health 09.2--public sector % of total on health 71
Italy--inf. mort. 7/1000--male life 75--female life 81--% of GDP spent on health 07.6--public sector % of total on health 70
Jap.--inf. mort. 4/1000--male life 77--female life 83--% of GDP spent on health 07.2--public sector % of total on health 78
UK--inf. mort. 7/1000--male life 75--female life 80--% of GDP spent on health 06.9--public sector % of total on health 84

Ranked by public sector % of of total spent on health
UK--inf. mort. 7/1000--male life 75--female life 80--% of GDP spent on health 06.9--public sector % of total on health 84
Fr.--inf. mort. 6/1000--male life 74--female life 82--% of GDP spent on health 09.7--public sector % of total on health 81
Ger.--inf. mort. 5/1000--male life 74--female life 80--% of GDP spent on health 10.5--public sector % of total on health 78
Jap.--inf. mort. 4/1000--male life 77--female life 83--% of GDP spent on health 07.2--public sector % of total on health 78
Can.--inf. mort. 6/1000--male life 76--female life 82--% of GDP spent on health 09.2--public sector % of total on health 71
Italy--inf. mort. 7/1000--male life 75--female life 81--% of GDP spent on health 07.6--public sector % of total on health 70
US-- inf. mort. 7/1000--male life 73--female life 80--% of GDP spent on health 14.0--public sector % of total on health 47


Nick Gill wrote:

> > maybe, instead of 'next of kin', how about 'emergency contacts'?  it seems a
> > good idea to ask for at least two contacts.  this may be too much detail, but
> > insurance numbers/patient numbers are as appropriate as allergies, asthma,
> > diabetes, esp.for folks enrolled in HMOs.  some ERs may not be willing to
>
> thanks for the idea. I'll point out that for an australian this sounds weird. Our health system may be crumbling under lack of funding and privatisation is on, but the idea of not being treated without this sort of info is not yet reality here, in general.
>
> What's an HMO?
>
> >  and remember that all areas do not have 911
> > numbers.
> Surely not? this would have to be the ultimate absurdity of the market ruling telecommunications. What sort of areas?
>
> We have a nationwide 000 emergency number. I believe all Telcos are mandated to support it.

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Received on Mon Dec 27 1999 - 09:41:46 PST

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