Posted by anne on May 21, 1999, at 16:45:57
In reply to Re: Med-Checks/Insurance for anne, posted by Elaine on May 20, 1999, at 23:31:34
Elaine,
If your policy provides for something more than med-checks, I wouldn't give up until you get what you are paying for. I seemed to have touched a raw nerve here. My point is not that this is the *best* medical care, but this is the kind of medical care middle-class people will be getting more of in the future. We have a 3-tiered system in the U.S. (the uninsured poor and near poor, employed middle class and relatively wealthy). Managed care arose because there were no gatekeepers with the old 80/20 insurance and having insurance increases demand for services. There were no incentives for docs to keep prices down or control utilization so we are now at the point where health care consumes about 14% of the gross national product. No other industrialized country comes close to this figure. Canada is closest to us at 9%, but Japan, Australia and the U.K. are in the 6-7% range. And they have universal coverage. Yes they have rationing in some form but we do too with managed care. That's all managed care is - a way to ration health care to keep it more affordable. Soon Medicare will go from a defined benefits plan to a defined contribution plan where everybody receives a fixed annual voucher with which they could purchase insurance or elect to stay with Medicare. But Medicare would be constrained by a fixed budget cap which would be maintained by cutting fees to providers when necessary. Thus, the risk of health care cost inflation would be transferred from the taxpayer to the Medicare beneficiary. This will segregate health care among seniors the way it is for working people.
Americans do not perceive health care as a social good the way Europeans do (implies available to all regardless of ability to pay). In the U.S. health care is seen as a private good (you get what you can afford) and this is unlikely to change.
poster:anne
thread:6242
URL: http://www.dr-bob.org/babble/19990501/msgs/6363.html