From: blais@milo.ifa.hawaii.edu (Kristin Blais)
Subject: Re: National Health Care
Organization: Institute for Astronomy, Hawaii
Date: Thu, 13 Aug 1992 04:08:40 GMT

In article <1992Aug12.030628.4113@news.columbia.edu> gld@cunixb.cc.columbia.edu (Gary L Dare) writes:
>blais@milo.ifa.hawaii.edu (Kristin Blais) writes:
>>I can't go to private doctors here by the way because a lot of them 
>>won't deal with independent insurers because of all the forms , 
>>the independent doctors here charge a fourtune to make sure they 
>>get wealthy clinetle who can afford to pay witout insurance.
>>:-)
>
>So they stayed with the old system that Canada and the U.S. once had,
>everybody pays cash?  (Health insurance did not pay off until the
>advent of high technology medicine, and Canada took the European lead
>with a French-style system of public basic and private supplementary
>coverage (mostly non-medical and travel).)
>

Not sure what you mean by "they" here. There are a bunch
of HMO's like Kaiser- all of them lousy in my opinion-
that are hospitals with staff on them. Then their are 
private doctors in Hawaii- who are generally the good ones
because they can afford to practice independant of 
the hospitals if they choose (Note the opposite is usually 
true on the mainland- that if a Doctor isn't on staff
at some hospital it's often for because the hospital doesn't want them
there or because they're way out in the country. 
My point was unless you can afford to go without insurance
you have to join one of the HMO's. Unlike many private
hospitals which run just to keep themselves in the black, 
these *companies* primary purpose is to make a profit 
NOT to provide the best health care they can, they don't have to
because the people who can afford private doctors will 
not use the HMO's generally anyway-so they know they've
got you. They cut costs by hiring doctors that often
have medical degrees from outside the USA and therefore 
are not accredited (Note we're not talking Europe, but
small schools on islands like Grenada). The only real
way they make money is by constantly signing up new members
who they are convinced won't use the service. This in fact 
makes for substandard medical care because they 
are always oversubscribed. (Sort of like the local gyms 
and health spas.) There *are* good points. I would
not be able to afford health care otherwise is one.
(It's $4.00 a doctors visit- tests are free, medication is 
discounted) However, I would much rather have a system
where the insurer has *nothing* to do with delivering the 
actual care. The system we have now would work if there
was only one company that insured people, that used one or two forms
for everything, everyone had to be covered, and if the profit
for the medical and insurance industries was set so that it 
isn't usurious. Like I said %100 profit above R&D for something 
such as heart medicine- which people need to stay alive is  
absolutely ridiculous and one of the reasons that 
medical care costs so much. The other thing is to cut down 
on the malpractice suits. All of these are raising the 
cost of medical care.
:-) 
Kristin
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