Re: [Paddlewise] briefing guide

I was all set to respond to Nick's query about HMOs, but felt that my level
of negative emotion -- generated by the mere mention of HMOs -- was too high
to do the job rationally.  My health insurance has been good to me, but what
I have seen as a health care provider for people in the lower income
brackets has made me seethe.  Richard has it exactly right.  Our third party
payer system is Robin Hood in reverse.

This is off topic.  Sorry Jackie, I won't do it again.  Promise.

-----Original Message-----
From: Richard Culpeper <culpeper_at_tbaytel.net>
To: Paddlewise_at_lists.intelenet.net <Paddlewise_at_lists.intelenet.net>
Date: Monday, December 27, 1999 12:43 PM
Subject: Re: [Paddlewise] briefing guide


>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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