From: John.Hamilton@kennel.fidonet.org
Newsgroups: rec.motorcycles
Subject: Re; Nat'l Health Plan (Was: Re: Lance Hols
X-Sender: newtout 0.07 Jan  3 1993
Date: 22 Jan 93  09:52:14

Thursday January 21 1993 16:38, Ron Mayer wrote to All:

 RM> IMHO the solution is that the insurance shouldn't pay for whatever one
 RM> doctor/patient combination they choose.  Instead, they should consider
 RM> the patient's condition, and if they don't like the doctor's
 RM> "estimate", they'd send out some their own insurance-adjustor doctor
 RM> to make his own estimate.  They then give the patient however much the
 RM> estimate says the problem would cost.  If the patient wants the more
 RM> expensive doctor, he pays the difference.  If the doctor can't fix it
 RM> for about the price of his estimate, he keeps working on for free
 RM> until he gets it right.  If a doctor screws up, he pays for the
 RM> damages he causes.

Yes, but who compensates the patient for the time it takes for the adjustor
to arrive, especially if a day or two makes a difference in the patient's
health? Of course, for surgery that is not time critical, most doctors will
suggest a second opinion if the patient is hesitant.

I have a Kaiser card. Despite the bad press accorded Kaiser from time to time,
I've received good care from them, and always see the same doctor when I need
one. I believe THIS is the form of a real health care solution. Group medicine
is growing in leaps and bounds, with HMO groups appearing everywhere. In
practice, everyone pays a little and most don't "use up what they paid". Sort
of like term life insurance, fire insurance, the like. Now, if the newly
elected Executive can find a way to get business, the wealthy, and government
to subsidize health care group membership for the financially disadvantaged,
everyone can have good health care at minimum cost.

When I wiped out last June, I dragged myself into Kaiser. It was a Sunday
morning and the emergency room was not very busy. I've seen it on Saturday
mornings just after midnight and its a war zone. Anyway, this being a "slow"
time, they could have done any number of needless or marginal procedures. But,
since they would only receive a total of $157 from all sources for my care
that month, they did only what was required: the bone guy tried to make me
wince by twisting my leg and shoulder, the nurse asked me too many questions
but at least she was sure I was coherent, the MD looked in my eyes with his
little light, and another nurse cleaned (with relish) and bandaged my leg.
At each step, they gave me hell about riding motorcycles, I can't imagine
why. Almost as good as having Mom there. :-)

I'm sure my motorcycle accident cost Kaiser more than $157 that month. But
tens of thousands of other people didn't come in that month, so they made out
just fine. They didn't do more than was necessary for me, but they didn't
do less, either.

I believe this is the form, or very close to it, of the future of medicine
(from a financial and organizational view) in the US. Its fair, it spreads
the burden of cost mostly onto the wealthy (big business), it could easily
be extended to those not able to afford care and not employed by a business
which provided coverage within the present financial framework of medicare/
medicaid/etc. with little additional funding. Of course, a whole gaggle of
doctors with private and professional group practices oppose ideas like this.
You alluded to the reason. The problem is not in doing it, but in getting by
people who have been raised to believe that as doctors, they have the right
to have 6 digit yearly incomes, and in tearing down a bureaucracy which has
been built up in both the public and private sector to support those beliefs.

I hope not to need medical assistance because of motorcycling in the future.
But if I do, and I end up in some emergency room far from home, the Kaiser
card in my wallet will eliminate any delay in receiving treatment. Though I
was raised with a "family doctor" who had ministered to 3 generations of
my family, I still find my present arrangement more than satisfactory.

John

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